Plastazote abduction orthosis in the management of neonatal hip instability.

Since 1987, 113 consecutive newborns with either Ortolani-positive or provocative-positive hip examinations in the newborn nursery have been treated with a Plastazote hip abduction orthosis when diagnosed and followed to determine if the method was safe, effective, and easy to use. Ortolani-positive hips often had bilateral abnormalities in the hip examination, were frequently associated with breech position, and were anatomically more dysplastic than those hips that were unstable by provocative testing. No patient developed ischemic necrosis during follow-up. Only two had additional treatment of their unstable hips. The rest had excellent results. Parents and caregivers found the device easy to use. The orthosis is recommended as the primary method for managing newborns with clinical instability to either the provocative or Ortolani test as being safe, effective, and easy to use across all skill levels.