Comparison Between Static and Dynamic Spica Cast for Closed Reduction Cases of DDH: A Short-Term Follow-Up

Background: developmental dysplasia of the hip (DDH) is a typical childhood disease that, if left untreated, can lead to early-onset osteoarthritis. Closed reduction and spica casting are the first line of treatment for infants aged 6-18 months. Static and dynamic spica casts are the two primary treatment method used in practice, but the evidence is mixed as to which method provides the best outcomes. Methods: This prospective, randomized, controlled trial compared static and dynamic spica casting in 98 DDH patients from Kurdistan, Iraq. Patients were divided into dynamic and static groups. The hip was follow-up ed by using radiographic parameters such as the acetabular index and Tonnis grade. Treatment success was defined as a favorable hip outcome after one year. Results: There was no significant difference in treatment success between the groups, with 68% of patients in both groups achieving normal hip modification. However, the dynamic cast group had significantly better acetabular indices at 3, 6, and 12 months, and all of them were done under general anesthesia (GA), better hygiene, better caring and more comfortable parents with less cost. Conclusions: Static and dynamic spica casting have similar short-term clinical success rates for DDH, but dynamic casting produces better radiographic outcomes, especially in infants younger than 1. Longer-term studies are needed to determine possible radiographic improvement and whether dynamic type translate into better clinical outcomes since its more comfortable for parent, with less cost.