Results of Pavlik Harness Treatment in Children With Dislocated Hips Between the age of six and Twenty-four Months

Pollet, Virginie; Pruijs, Hans; Sakkers, R. J. B.; Castelein, René M.

doi:10.1097/bpo.0b013e3181df85ab

Cited by 42 publications

(47 citation statements)

References 15 publications

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“…However, a recent retrospective study of the outcome of late-diagnosed DDH in infants who were treated with Pavlik harness beginning treatment at the age of 6-24 mo, showed encouraging results in the treatment of hip dislocation type Graf 3. Neither of the Graf 4 hips were successfully reduced [98] . Another study reported a successful treatment with Pavlik harness, in children aged 5 to 13 mo of age.…”

Section: The Pavlik Harnessmentioning

confidence: 99%

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

Kotlarsky

Reuben

Bialik

et al. 2015

WJO

249

244

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Section: The Pavlik Harnessmentioning

confidence: 99%

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

Kotlarsky

Reuben

Bialik

et al. 2015

WJO

249

244

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“…The switch from Pavlik to Camp within this time frame was supported by the thought that after stable reduction was managed using the Pavlik harness the residual dysplasia could now safely be treated with a more patient (parent) friendly abduction device. The prolonged use of the Pavlik harness was based on reports of successful reduction after the prolonged use of the Pavlik harness by van der Sluijs et al and Pollet et al [10, 13]. …”

Section: Methodsmentioning

confidence: 99%

“…Although late-diagnosed hip dislocations are now rarely seen because of national screening programmes, they still present a significant challenge in their management and literature supporting any treatment protocol remains scarce [2, 10]. In The Netherlands newborns at risk, or after a positive clinical examination, are to be screened with ultrasound at six–12 weeks as timely intervention can then be managed with a Pavlik harness, possibly followed by a Camp abduction brace if the result after Pavlik treatment is not satisfactory [7].…”

Section: Introductionmentioning

confidence: 99%

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Successful Pavlik treatment in late-diagnosed developmental dysplasia of the hip

Sande

Melisie

2012

International Orthopaedics (SICOT)

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PurposeThe objective of this study was to evaluate success and complication rates of the Pavlik harness in late-diagnosed hip dislocation (developmental dysplasia of the hip, DDH). We also set out to assess the additional value of an abduction brace for three to six months, when successful reduction using the Pavlik harness was achieved.MethodsWe included 31 patients (31 hips, 28 female, right/left = 4/27) with late-diagnosed hip dislocation treated with a Pavlik harness between 1995 and 2008. The average age at the start treatment was 27 weeks (21-57). None were lost to follow-up; the mean follow-up was 4.2 years (two-10). Of these patients, 61 % were classified as Tönnis type 2, 32 % as type 3 and 7 % as type 4.ResultsOf 31 hips, 20 (65 %) were successfully reduced after the use of the Pavlik harness. The average duration of Pavlik treatment was seven weeks (three-12). The mean time to stable reduction was six weeks (three-11), after which the patients were weaned off the Pavlik harness. The mean age at final treatment was 19 months (12-28). Five patients (15.0 %) developed radiological signs of osteonecrosis (Kalamchi and MacEwen classification; two group I, one group II and two group IV). When we compared the different Tönnis types a significant difference in successful reduction was found. Seventeen (81 %) of Tönnis type 2 dislocated hips were successfully reduced, while only two (25 %) of Tönnis type 3-4 hips were (odds ratio 25, p = 0.001). Clinical examination (e.g. limited abduction, positive Ortolani, Barlow or Galeazzi) at the time of diagnosis was not significantly related to the success rate of the Pavlik treatment. The mean acetabular index (AI) significantly improved from 36.5 to 30.5° after initial Pavlik treatment to 22.3° at final follow-up (4.1 years).ConclusionsProlonged use of the Pavlik harness in late-diagnosed hip dislocation (DDH) Tönnis type <3 is a safe and successful treatment option in the older infant. Although the AI was significantly reduced after the abduction brace, its additional use remains debatable, as no control group was evaluated.

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“…A retrospective study was conducted by (Pollet et al, 2010) showed encouraging results with patients starting treatment at the age of 6-24 months of age.…”

Section: Introductionmentioning

confidence: 99%