Pavlic harness in management developmental dysplasia of the hip

ABSTRACT

Developmental Dysplasia of the Hip, DDH - preferred term, also Teratogenic hips, Subluxation and Dislocation-usually posterosuperior [reducible vs irreducible], or Dysplasia are the range of hip problems usually encountered. Risk Factors are, 1/1,000 born with dislocated hip, 10/10,000 born with subluxation or dysplasia, 80% Female and first born children. Also Family history [6% one affected child, 12% one affected parent, 36% one child + one parent], pregnancy related problems as Oligohydramnios, Breech [sustained hamstring forces], Native Americans [swaddling cultures], Left 60% [left occiput anterior], while Right 20%, both 20%, Torticollis or LE deformity. Best if treated before 6 weeks of age 0 - 6 months of age, the Pavlik harness is used, at 6 - 18 months Closed vs open reduction and spica casting is usually successful. At 18-48 months, closed reduction versus Open reduction +/- osteotomies of the femur, pelvis, or both is preferred