| Title | Prolonged treatment with the Pavlik harness in infants with developmental dysplasia of the hip. | | Author(s) | van der Sluijs JA, De Gier L, Verbeke JI, Witbreuk MM, Pruys JE, van Royen BJ | | Institution | Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands. ja.vandersluijs@vumc.nl | | Source | J Bone Joint Surg Br 2009 Aug; 91(8):1090-3. | | MeSH | Acetabulum
Braces
Female
Femur Head Necrosis
Hip Dislocation, Congenital
Humans
Infant
Prospective Studies
Time Factors
Treatment Outcome
Weight-Bearing
| | Abstract | We prospectively studied the benefits and risks of prolonged treatment with the Pavlik harness in infants with idiopathic developmental dysplasia of the hip. Bracing was continued as long as abduction improved. It was started at a mean age of four months (1 to 6.9). Outcome measures were the number of successful reductions, the time to reduction, the acetabular index and evidence of avascular necrosis at follow-up at one year. In 50 infants with 62 subluxated and dislocated hips (42 Graf type III and 20 type IV), 37 were reduced successfully with a mean time to reduction of 13.4 weeks (sd 6.8). Bracing was successful in 31 type-III (73.8%) and in only six type-IV hips (20%, p = 0.002). Avascular necrosis was seen in ten hips. Prolonged treatment with the Pavlik harness for developmental dysplasia of the hip over the age of one month can be beneficial in type-III hips, but it is unclear as to whether this is the optimal treatment, since it may postpone the need for closed or open reduction to a more unfavourable age. The use of the Pavlik harness in type-IV hips in this age group is questionable, but if used, prolonged bracing is not advised. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19651841 |
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