Home traction in the treatment schedule of overhead traction for developmental dysplasia of the hip.

Background: Our department introduced an overhead traction method (OHT) into the treatment protocol for developmental dysplasia of the hip (DDH) in 1964. With our method, a minimum of 6 weeks of hospitalization was necessary, and the burden for the patients and their families was significant. Since 1998, we have employed home traction into the OHT protocol to shorten the duration of hospitalization. The objective of this study was to investigate the efficacy and safety of home traction in the treatment schedule of OHT for DDH.

Method: Home traction was employed for most of the horizontal traction period after initial hospitalization for orientation. We compared 20 patients who underwent home traction in the OHT treatment schedule (Home T group) with 20 patients who underwent hospital traction for the entire period (Hosp. T group). The effect of traction, the complications during traction, the presence or absence of developing avascular necrosis, the total duration of hospitalization, and the total duration of treatment were investigated in the two groups.

Results: There were no significant differences in the effect of traction, frequency of complications during traction, or frequency of avascular necrosis after reduction between the Home T and Hosp. T groups. The mean durations of hospitalization were 28.5 and 45.9 days for the Home T and Hosp. T groups, respectively. There was no significant difference in the total duration of treatment between the two groups.

Conclusions: Home traction in the OHT schedule is safe and useful because it can shorten the hospitalization period with a traction effect equal to that of hospital traction and without significant differences in complications. A short-term instructive hospitalization period may be useful to reduce the disadvantages of home traction, that is, unreliable performance of traction and increased anxiety of the family.