Congenital dislocation of the hip in boys.

Borges, J. L. P.; Kumar, Shikhar; Guille, James T.

doi:10.2106/00004623-199507000-00001

Cited by 42 publications

(28 citation statements)

References 32 publications

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“…Although the authors agreed with a previously published study [1] which suggested that male gender may also be a risk factor for failure, several other studies have not found a correlation between gender and failure of Pavlik harness treatment. A more comprehensive, adequately powered review is needed to resolve some of these controversies.…”

Section: Where Do We Need To Go?supporting

confidence: 87%

CORR Insights ® : Higher Pavlik Harness Treatment Failure Is Seen in Graf Type IV Ortolani-Positive Hips in Males

Thacker

2016

Clinical Orthopaedics &Amp; Related Research

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Section: Where Do We Need To Go?supporting

confidence: 87%

CORR Insights ® : Higher Pavlik Harness Treatment Failure Is Seen in Graf Type IV Ortolani-Positive Hips in Males

Thacker

2016

Clinical Orthopaedics &Amp; Related Research

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“…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%

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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“…Only one previous study reported an association between male sex and a high risk of failure of Pavlik harness treatment [4]. Numerous studies [2,13,14,17,19,20,24,32] have not shown this association; however, these studies may have been limited in power owing to a small number of male patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are conflicting results regarding age [13,14,31,32], sex [4,13,14,31,32], bilaterality [10,14,20,31], and ultrasound findings at initial examination [10,16,19,24,28,30,32]. Methods of data collection in these previous retrospective studies have varied, and they did not address the full spectrum of potential factors that may lead to failure such as detailed patient and family history, physical examination, and ultrasound findings.…”

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

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show abstract

Congenital dislocation of the hip in boys.

Cited by 42 publications

References 32 publications

CORR Insights ® : Higher Pavlik Harness Treatment Failure Is Seen in Graf Type IV Ortolani-Positive Hips in Males

CORR Insights ® : Higher Pavlik Harness Treatment Failure Is Seen in Graf Type IV Ortolani-Positive Hips in Males

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

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