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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 8, 1090-1093.
doi: 10.1302/0301-620X.91B8.21692  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Prolonged treatment with the Pavlik harness in infants with developmental dysplasia of the hip

J. A. van der Sluijs, MD, PhD, Orthopaedic Surgeon1; L. De Gier, MSc, Medical Intern1; J. I. Verbeke, MD, Paediatric Radiologist2; M. M. E. H. Witbreuk, MD, Orthopaedic Surgeon1; J. E. H. Pruys, MD, PhD, Orthopaedic Surgeon3; and B. J. van Royen, MD, PhD, Professor1

1 Department of Orthopaedic Surgery
2 Department of Radiology VU Medical Centre, Boelelaan 1117, 1007 MB Amsterdam, The Netherlands.
3 Department of Paediatric Orthopaedic Surgery Wilhelmina Kinderziekenhuis, Lundlaan 6, 3508 AB, Utrecht, The Netherlands.

Correspondence should be sent to Dr J. A. van der Sluijs; e-mail: ja.vandersluijs{at}vumc.nl

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.




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Our experience with the treatment of DDH by Pavlik harness
Zoran S. Vukasinovic, et al.
J Bone Joint Surg Br Online, 10 Aug 2009 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General