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

Atalar, Hakan; Şaylı, Uğur; Yavuz, Osman Yüksel; Uraş, İsmail; Doğruel, Halil

doi:10.1007/s00264-006-0097-8

Cited by 101 publications

(133 citation statements)

References 25 publications

Supporting

Mentioning

111

Contrasting

Unclassified

Order By: Relevance

“…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]. The results of the present study revealed that both a lower initial a angle and a worse Graf hip type decrease the Pavlik harness treatment success rate.…”

Section: Discussioncontrasting

confidence: 59%

“…There are few data on the success rate of Pavlik harness treatment in ultrasonographic hip types other than Graf Type III and IV hips. The reported treatment success rate with the Pavlik harness is higher in such hips [3,9,31]. The success rate of Pavlik harness treatment was more than 90% in Graf Type IIa-hips, approximately three-fourths in Type IIb hips, and approximately two-thirds in Types IIc and D hips in the present study.…”

Section: Discussionsupporting

confidence: 40%

“…The results of the previous studies have shown that considerably higher success rates can be obtained if Pavlik harness treatment is started before the age of 2 to 3 months [3, 6, 9-11, 26, 31]. Bilateral involvement [3,13,26], having two or more risk factors for DDH [12], and male gender [5] are the reported patient-related variables that correlated with a higher rate of failure in Pavlik harness treatment. The results of the present study revealed that the treatment-starting age was the only patient-related variable, with older patients being much more likely to fail treatment.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

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°-

show abstract

Section: Discussioncontrasting

confidence: 59%

Section: Discussionsupporting

confidence: 40%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

show abstract

“…Greater than 90% success may be expected in hips that are stable on examination but dysplastic on ultrasound images [8] and for those dislocatable with the Barlow [3] maneuver [6,12,14,25]. However, treatment failures of 30% to 60% have been reported in dislocated reducible Ortolani-positive hips [2,14,16,19,20,24,[30][31][32]. Failure of the Pavlik harness method has been associated with an increased risk of osteonecrosis of the femoral head [29].…”

Section: Introductionmentioning

confidence: 99%

“…(2) What are the factors predictive of failure of Pavlik harness treatment for Ortolani-positive hips?…”

Section: Introductionmentioning

confidence: 99%

Higher Pavlik Harness Treatment Failure Is Seen in Graf Type IV Ortolani-positive Hips in Males

Novais

Kestel

Carry

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

Common Childhood Orthopaedic Conditions, their Care and Management

Judd

2014

Orthopaedic and Trauma Nursing

View full text Add to dashboard Cite

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

Abstract: This study examined the outcomes of ultra-

Cited by 101 publications

References 25 publications

Success of Pavlik Harness Treatment Decreases in Patients ≥ 4 Months and in Ultrasonographically Dislocated Hips in 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

Higher Pavlik Harness Treatment Failure Is Seen in Graf Type IV Ortolani-positive Hips in Males

Common Childhood Orthopaedic Conditions, their Care and Management

Contact Info

Product

Resources

About