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

Taylor, G. R.; Clarke, Nicholas

doi:10.1302/0301-620x.79b5.0790719

Cited by 51 publications

(28 citation statements)

References 16 publications

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“…Our data indicated that the success rate was 84 % and this rate was lower than that reported by (Taylor et al, 1997) as they got 95.7% successful reduction with Pavlik harness in their cases. Similar results was reached by (Grill et al, 1988) as they got 95.35% healing rate in infant with dysplastic hips but they observed Avascular necrosis of the femoral head in 2.38% of their cases.…”

Section: Resultscontrasting

confidence: 73%

Pavlik Harness in Treatment of Developmental Dysplasia of the Hip Joint a Prospective Short Term Follow up Clinical Study

Hadi¹,

Fouad²,

Shaban³

2018

Int.J.Curr.Res.Aca.Rev.

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Section: Resultscontrasting

confidence: 73%

Pavlik Harness in Treatment of Developmental Dysplasia of the Hip Joint a Prospective Short Term Follow up Clinical Study

Hadi¹,

Fouad²,

Shaban³

2018

Int.J.Curr.Res.Aca.Rev.

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“…The initial ultrasound assessment showed 65.8% to be displaced and 17.9% to be dislocated. They report that 16 hips (4.3%) failed to reduce, requiring further treatment, 7 hips (3.2%) showed continued dysplasia at 5 years and 0.3% had mild avascular necrosis [12]. The use of ultrasound during splintage also allows the monitoring of the adequacy of treatment, identifying failure early in order to allow a change in management [13].…”

Section: Introductionmentioning

confidence: 99%

The use of X-ray at 5 months in a selective screening programme for developmental dysplasia of the hip

Price¹,

Dove

Hunter³

2011

Journal of Children's Orthopaedics

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Background The methods used for any screening programme for developmental dysplasia of the hip (DDH) can be controversial. This was an opportunistic audit of our selective ultrasound screening programme using an X-ray at 5 months to prevent inappropriate discharge due to the learning curve of ultrasound. Methods Between 1990 and 2004 in Nottingham, UK, out of a total population of 108,500 births, approximately 11,500 neonates were screened using ultrasound. Any child with an ultrasound scan showing Graf a-angles greater than 60°(Graf Type I) with the hip in joint were discharged from the clinic. All of those discharged were subsequently X-rayed at 5 months in order to cover the learning curve of ultrasound. The X-rays were reviewed by a consultant radiologist and referred back to orthopaedics if there was lateralisation of the femoral head or an acetabular index above 30°.Results Of approximately 11,000 X-rays performed, only 53 patients were referred back to orthopaedics, of which 47 had a complete data set. Of these 47 children, only 8 (17%) required intervention. On review of the original ultrasounds, Graf's a-angle did not seem to correlate well with the need for intervention, as all were Type I hips. The femoral head cover (FHC) appeared to be more predictive of the need for treatment. There have been no late presentations to our unit of DDH following a normal 5-month X-ray. Conclusions We now check the Graf a-angle, FHC and dynamic stability in the ultrasound assessment and only perform X-ray at 5 months if there was a low a-angle or low FHC. Since this change, there have been no late presentations of DDH from the population screened by ultrasound.

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“…After initial clinical assessment, patients treated in this way were reviewed weekly using a static ultrasound [16].…”

Section: Methodsmentioning

confidence: 99%

Pseudoparalysis in the Pavlik Harness: Beware of septic arthritis

Stevenson

Shewalle

Clarke

2007

Journal of Children's Orthopaedics

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Purpose Pseudoparalysis of the leg occurring during use of the Pavlik Harness (PH) is a seldom-reported condition. Three cases of pseudoparalysis are reported here to illustrate the need for careful assessment of this condition. Methods A series of patients using the PH and presenting with pseudoparalysis was compiled following a retrospective review of case notes. Results In 3 cases, infants treated for developmental dysplasia of the hip using the PH were found to have developed a pseudoparalysis of the affected limb. All presented with similar signs, with the infant being systemically irritable and reluctant to move the limb. In 2 of the cases, this was related to the harness-its removal resulted in recovery of the affected limb. The third case was proven to be septic arthritis, unrelated to the harness, and treatment by means of arthrotomy, intravenous antibiotics and use of the PH for hip stabilisation was used successfully. In the first two cases, the pseudoparalysis was noticed at routine review clinic, and clinical assessment, ultrasound scan and blood tests were performed. The case of septic arthritis was similarly assessed, following referral by paediatric physicians. Conclusion Pseudoparalysis in the PH is a rare event and requires careful investigation.

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

Cited by 51 publications

References 16 publications

Pavlik Harness in Treatment of Developmental Dysplasia of the Hip Joint a Prospective Short Term Follow up Clinical Study

Pavlik Harness in Treatment of Developmental Dysplasia of the Hip Joint a Prospective Short Term Follow up Clinical Study

The use of X-ray at 5 months in a selective screening programme for developmental dysplasia of the hip

Pseudoparalysis in the Pavlik Harness: Beware of septic arthritis

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