Long-Term Results of Congenital Dislocation of the Hip Treated with the Pavlik Harness

Developmental dysplasia of the hip: What has changed in the last 20 years?

“…Continuation of the harness with the dislocated hip may potentiate acetabular dysplasia, which may increase the difficulty of subsequent closed reduction ("Pavlik harness disease") [84,85] . Higher rates of AVN have also been reported [86][87][88][89][90][91] . A recent study examined the influence of different risk factors (age, gender, side, family history, breech presentation, first-born girl, oligohydramnios, swaddling, and the severity of hip dysplasia defined by ultrasonography) on the success rate of treatment with the Pavlik harness.…”

Financial justification for routine ultrasound screening of the neonatal hip

“…This would appear to negate the criticism that routine screening leads to increased rates of intervention and an increased risk of avascular necrosis by splinting hips in abduction. The incidence of this complication has been quoted as being between 0% and 22%, 25,26 but by close supervision and weekly review using ultrasound it has not so far occurred in our series. All children with abnormal scans are followed at least until walking age when plain radiography is performed.…”

Monitoring the Treatment of Developmental Dysplasia of the Hip With the Pavlik Harness

“…There is little published evidence of such a long-term review of a treated population. 7,8 In our series to date, the incidence of mild acetabular dysplasia is 4.3%. It has not been possible to relate these to factors in the history, treatment or ultrasound appearance which would have been predictive at an early stage.…”

“…6 In the longer term, it is still uncertain how long review should be continued to assess late acetabular dysplasia. 7,8 For these patients, the long-term prospective results of a 'defined population' are still required to identify early predictive features.…”