Early Failure of Pavlik Harness Treatment for Developmental Hip Dysplasia: Clinical and Ultrasound Predictors

Lerman, Joel A.; Emans, John B.; Millis, Michael B.; Share, Jane; Zurakowski, David; Kasser, James R.

doi:10.1097/01241398-200105000-00017

Cited by 97 publications

(117 citation statements)

References 18 publications

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“…In previous studies, it has been reported that the side of pathology and the infant's gender do not affect the result of Pavlik harness treatment [3,9,14]. Our findings support these findings.…”

Section: Discussionsupporting

confidence: 83%

“…The risk factors cited most often for failure of Pavlik harness treatment in DDH include bilateral dislocation [22], low α angle and low percentage of coverage on ultrasound [9], initial irreducibility, and advanced age at the start of treatment [3,22]. Viere et al [22] found an increased likelihood of failure of Pavlik harness treatment in patients with bilateral involvement, whereas Harding et al [3] found no such increase.…”

Section: Discussionmentioning

confidence: 86%

“…Lerman et al [9] reported that age at diagnosis and initiation of treatment did not correlate with failure in treating DDH with the Pavlik harness whereas, Viere et al [22] reported that initiating Pavlik harness treatment after Fig. 3 The effects of Graf type on treatment results.…”

Section: Discussionmentioning

confidence: 99%

“…Lerman et al [9] reported that Pavlik harness treatment was unsuccessful in 26 out of 137 patients. The authors concluded that irreducibility on physical examination combined with an ultrasound coverage of less than 20% defines a patient group that uniformly fails Pavlik harness treatment.…”

Section: Discussionmentioning

confidence: 99%

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Indicators of successful use of the Pavlik harness in infants with developmental dysplasia of the hip

Atalar

Şaylı

Yavuz

et al. 2006

International Orthopaedics (SICOT)

101

111

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Indicators of successful use of the Pavlik harness in infants with developmental dysplasia of the hip

Atalar

Şaylı

Yavuz

et al. 2006

International Orthopaedics (SICOT)

101

111

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“…The reported ultrasonographic predictors of failure or complications in DDH treated by the Pavlik harness are an initially lower a angle (\43°), higher b angle, and a worse hip type (Graf Types III and IV hips) [1,14,31]. The reported success rate of Pavlik harness treatment in Graf Type III and IV hips is not as high as the other Graf hip types [3,16,21,22,25,31].…”

Section: Discussionmentioning

confidence: 99%

Success of Pavlik Harness Treatment Decreases in Patients ≥ 4 Months and in Ultrasonographically Dislocated Hips in Developmental Dysplasia of the Hip

Ömeroğlu

Köse

Akceylan

2016

Clinical Orthopaedics &Amp; Related Research

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Background Treatment of developmental dysplasia of the hip (DDH) using the Pavlik harness has been a widely used method in patients between 0 and 6 months of age for many years. However, the factors influencing the success rate of this treatment modality have still not exactly been determined as a result of the limited number of clinical studies with higher level of evidence. Questions/purposes We, therefore, asked whether (1) patient-related variables such as age, gender, and laterality; coexisting risk factors including family history, breech presentation, intrauterine packing, first-born girl, oligohydroamnios, and swaddling; and (2) the severity of hip dysplasia, defined by ultrasonography, are associated with differences in the success rate of Pavlik harness treatment in infants with DDH. Methods Between 2012 and 2014, we treated 153 children (B 6 months of age) with DDH using the Pavlik harness. Hip dysplasia apart from coexisting neuromuscular disorders, congenital abnormalities, or syndromes was our inclusion criteria. Of patients thus treated, 130 (85%) were available for the evaluation of patient-and hip-related variables against the success of Pavlik harness treatment. Mean age of these patients on day of diagnosis and initiation of treatment was 108 days. The diagnostic and followup examinations of the hips were made by ultrasonography using Graf's method. Pavlik harness treatment was initiated in Graf Type IIa-and worse hips and treatment was considered ''successful'' when a Graf Type I hip was achieved. Pavlik harness treatment was successful in 92 (71%) patients (130 of 181 hips [72%]). Results Age was the only patient-related variable influencing the success rate of the treatment; the mean age of children in whom Pavlik harness treatment succeeded (97 ± 38 days; 95% confidence interval [CI], 90-112) was lower than the age of those who failed (135 ± 37 days; 95% CI, 123-147; p \ 0.001). The highest success rate was obtained in children younger than age 3 months (37 of 40 [93%]) and the lowest one older than age 5 months (nine of 24 [37%]) (p \ 0.001). The threshold age value related to an increased risk of failure was found to be 4 months and older, which had a sensitivity of 66% and a specificity of 77% (p \ 0.001). A higher initial a angle was observed in the hips in which the treatment succeeded (53°± 6°; 95% CI, 51°-53°) than in those that failed (47°± 7°; 95% CI, 45°-

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Developmental Dysplasia of the Hip

Paton

2011

Examination of the Newborn

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Early Failure of Pavlik Harness Treatment for Developmental Hip Dysplasia: Clinical and Ultrasound Predictors

Cited by 97 publications

References 18 publications

Indicators of successful use of the Pavlik harness in infants with developmental dysplasia of the hip

Indicators of successful use of the Pavlik harness in infants with developmental dysplasia of the hip

Success of Pavlik Harness Treatment Decreases in Patients ≥ 4 Months and in Ultrasonographically Dislocated Hips in Developmental Dysplasia of the Hip

Developmental Dysplasia of the Hip

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