The creation of a Pavlik “hemi-harness” for a singly irreducible hip in bilateral dysplastic hips

Abstract

Purpose The treatment of bilaterally dislocated hips with a Pavlik harness can have deleterious effects if one hip remains dislocated. We assess the success of potentially leaving the persistently dislocated hip free and the relocated hip in a “hemi-Pavlik” harness. Methods In this report, we retrospectively review three cases of bilaterally dislocated hips in children who were treated with a Pavlik harness. Only one hip was effectively reduced by the harness and, in each case, half of the harness was cut away to create a “hemi-Pavlik” harness and the free side was operated on at a later date. Results Initial follow-up has shown that the “hemi-Pavlik” harness is effective in maintaining reduction of one hip whilst leaving the other hip untreated, thus, avoiding the complications of prolonged use of the harness in an unreduced hip or having both hips dealt with operatively. Conclusions We suggest, in the early stages, that if only one side of the bilaterally displaced hips can be reduced, the non-reduced side should be left free and an elective procedure carried out at a later stage. In the early stages, a “hemi-Pavlik” harness is effective in treating the reducible hip and causes no treatment obstacles for the irreducible side.

The effect of the design of the orthosis on the axial load transmission of two flexion abduction orthoses used in treating congenital hip dysplasia

“…In regard to the design however, the orthoses are quite different [ 13 , 5 , 19 , 20 , 21 ]. There are orthoses with an abdominal or chest strap and splints without intermediate fixation.…”