Ineffective hip rotation with Pavlik harness. Prospective study of 35 infant dislocations.
35 hips in 31 infants diagnosed as unstable were treated with a Pavlik harness and followed by weekly clinical and monthly ultrasound evaluation to determine eventual stability. 26 hips became stable within 3 months, and 9 dislocations required reduction with hip spica placement; 1 of these subsequently required open reduction. Of the 7 infants with 9 hips that failed, 2 children had a late onset of treatment, 2 children had problems with brace fit or family acceptance, and 3 other children had no problem with use of the orthosis. Internal rotation of a degree not possible with the Pavlik harness was required to reduce 4 of these 9 hips. The Pavlik harness is ineffective in some patients because of the need for internal rotation.
Hunter
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Department of Radiology, University of California, Irvine, Orange 92668.
Hoffer
M M
MM
Thomas
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L
Rosenfeld
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S
Weinert
C
C
D001175:Arthrography; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007593:Joint Instability / Q000628:therapy; D008297:Male; D009989:Orthotic Devices; D011446:Prospective Studies; D012399:Rotation; D017211:Treatment Failure; D014463:Ultrasonography