An evaluation of clinical and ultrasound results of Pavlik harness treatment for developmental dysplasia of the hip

Abstract

Developmental dysplasia of the hip (DDH) is the instability or dislocation of the hip joint at birth that may occur in utero, during infancy, and childhood. This condition was identified as an important challenge. This study aimed to determine the clinical and ultrasound results of Pavlik harness treatment for DDH in patients referred to the pediatric clinic of Imam Khomeini Hospital in Ahvaz. This is a descriptive cross-sectional study in which 100 newborns aged 15 to 30 days were included by the census method after obtaining parental consent. Follow-up of the infants was performed at 3 and 6 months after treatment. All analyzes were performed using SPSS version 22 at a significance level of 0.05. The results showed that the mean age of the infants was 23.46±2.12 days, of which 33 infants were boys and 67 girls. The involvement on the right and left sides was 39% and 50%, respectively, and 11% of the infants had bilateral involvement. The mean value of acetabular index before placement was 25.48±6.509 and 26.38±3.866 on the right and left sides, which after 3 months of placement, was reduced to 21.62±2.578 and 21.57±2.839, respectively. Pavlik harness treatment was associated with acceptable radiological results in infants. This technique seems to be a suitable and applicable attempt to treat this problem and prevent serious and irreversible complications of late diagnosis.

Standardized In-harness Ultrasound Protocol Improves Success Rate of Brace Treatment for Dislocated Hips

“…Ultimately, 28 hips in the NSUS group underwent additional procedures under anesthesia: closed reduction alone, 10 closed reduction with adductor tenotomy, 5 and open reduction. 13 In the standardized group, there were 8 hips (15.1%) that remained dislocated and underwent closed reduction alone, 2 closed reduction with adductor tenotomy, 1 and open reduction 5 including one who also had concomitant pelvic osteotomy performed. Risk factors related to those who failed the Pavlik harness are in Table 3.…”

“…3 The Pavlik harness is one of the most utilized orthoses for treating hip dislocations. [3][4][5][6] It is well established that early intervention is highly effective, with the success rate of Pavlik harness treatment ranging from 58% to 97%. [7][8][9][10] Monitoring for success with the brace can be challenging, as clinical examination alone has been shown to be unreliable, even amongst those with substantial experience managing DDH.…”

“…For infants younger than 6 months of age with a hip dislocation, treatment with a Pavlik harness is initiated to guide the hip back into the socket by directing the lower extremities into a flexed and abducted position 3 . The Pavlik harness is one of the most utilized orthoses for treating hip dislocations 3–6 . It is well established that early intervention is highly effective, with the success rate of Pavlik harness treatment ranging from 58% to 97% 7–10 .…”

Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle?

“…Within this population there are some features that have been raised and risk factors identified including family history and genetics ( Shaw et al, 2016 ; Swarup et al, 2018 ; Harsanyi et al, 2020 ; Zhang et al, 2020 ). The incidence of unilateral hip dysplasia is greater on the left side than the right, and only a small subset (∼10%) of patients exhibit bilateral hip dysplasia ( Mousavibaygei et al, 2022 ).…”

“…The incidence of unilateral hip dysplasia is greater on the left side than the right, and only a small subset (~10%) of patients exhibit bilateral hip dysplasia (Mousavibaygei et al, 2022).…”