Treatment of Congenital Hip Dislocation and Dysplasia with the Pavlik Harness

To Screen or Not to Screen? A Decision Analysis of the Utility of Screening for Developmental Dysplasia of the Hip

“…When developing an algorithm, definitions and delineations need to be made within the spectrum of developmental dysplasia of the hip. Hips with teratologic dislocations, including those resulting from myelodysplasia, arthrogryposis, chromosomal abnormalities, and dislocation due to cerebral palsy and skeletal dysplasia, were excluded because such hips respond differently to treatment, as documented in most of the literature on this topic 21,22 . For the purposes of the present study, we differentiated between acetabular dysplasia and a dislocatable or subluxatable hip.…”

Frejka pillow and Becker device for congenital dislocation of the hip: Prospective 6-year study of 104 late-diagnosed cases

“…The combined Frejka-Becker treatment approximated the ideal device criteria (Johnson et al 1981). In most patients, the Frejka pillow allowed gentle reduction and the Becker device maintained a concentric reduction.…”

“…In the outpatient treatment for CDH in children under I year of age, the Pavlik harness has probably become the most commonly used method. While it seems to be simple, safe and successful, serious iatrogenic complications like avascular necrosis are still reported (Pavlik 1957, Ramsey and Lasser 1976. Johnson et al 1981, Tonnis 1982, Grill et al 1988) and the simplicity of the Pavlik harness has been disputed (Mubarak et al 1981).…”

“…Both devices are simple in design and application, they permit mobility, and are inexpensive. For outpatient treatment with the Pavlik harness, other studies report a success rate of 80-92 percent and femoral head necrosis in 0-7 percent (Pavlik 1957, Ramsey and Lasser 1976, Johnson et al 1981, Mubarak et al 1981, Tonnis 1982, Grill et al 1988. Visser (1984) found in children whose treatment (tractiodplaster of Paris) was started within the first 2 years of life a success rate of 93 percent and necrosis in 5 percent.…”

Errors of diagnosis and the initiation of conservative treatment in children with congenital hip dislocation

“…В первые двое-трое суток после установки ортопедической конструк-ции могут наблюдаться: выраженное беспокой-ство ребенка на протяжении нескольких часов, отказ от еды, болевая контрактура -отсутствие активных движений в конечности, болезненность пассивных движений, отек области сустава, изме-нение цвета кожных покровов. В подобных слу-чаях необходимо снять конструкцию, назначить обезболивающие и нестероидные противовоспа-лительные препараты, несколько раз в день ис-пользовать теплые ванны, расслабляющий массаж [37,40,41].…”