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. 2022 Oct 10;2022(10):CD012717. doi: 10.1002/14651858.CD012717.pub2

Summary of findings 2. Dynamic splinting versus static splinting for the non‐operative management of developmental dysplasia of the hip in babies under six months of age.

Dynamic splinting versus static splinting for the non‐operative management of developmental dysplasia of the hip in babies under six months of age
Patient or population: babies under six months of age with stable and unstable hips
Setting: hospitals
Intervention: dynamic splinting
Comparison: static splinting
Outcomes № of babies
(studies)
Certainty of the evidence
(GRADE) Impact
Measurement of acetabular index at 1 year
Assessed with: radiographs (angle)
0
(0 RCTs)
No data presented and it is unclear if the outcome was measured.
Measurement of acetabular index at 2 years
Assessed with: radiographs (angle)
0
(0 RCTs)
No data presented and it is unclear if the outcome was measured.
Measurement of acetabular index at 5 years
Assessed with: radiographs (angle)
0
(0 RCTs)
No data presented and it is unclear if the outcome was measured.
Need for operative intervention 0
(0 RCTs)
No data presented and it is unclear if the outcome was measured.
Complications: avascular necrosis at 4 months
Assessed with: grading systems (not stated)
118 hips
(1 RCT)
⊕⊝⊝⊝
Very lowa,b One RCT reported no occurrence of avascular necrosis in either group.
*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence interval; DDH: developmental dysplasia of the hip; RCT: randomized controlled trial
GRADE Working Group grades of evidenceHigh certainty: we are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect
Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect

aWe downgraded the certainty of the evidence by one level for risk of bias, as we judged risk of bias as generally unclear in all domains except incomplete outcome data, due to limited details reported in the trial report.
bWe downgraded the certainty of the evidence by two levels for imprecision, due to there only being one small study.