Treatment for developmental dysplasia of the hip using the Pavlik harness: long-term results.
We reviewed the medical records of 115 patients with 130 hips with developmental dysplasia with complete dislocation in the absence of a neuromuscular disorder, spontaneous reduction with a Pavlik harness, and a minimum of 14 years' follow-up. The mean age at the time of harness application was 4.8 months (1 to 12) and the mean time spent in the harness was 6.1 months (3 to 12). A total of 108 hips (83.1%) were treated with the harness alone and supplementary surgery for residual acetabular dysplasia, as defined by an acetabular index > 30 degrees , was performed in 22 hips (16.9%). An overall satisfactory outcome (Severin grade I or II) was achieved in 119 hips (91.5%) at a mean follow-up of 16 years (14 to 32) with a follow-up rate of 75%. Avascular necrosis of the femoral head was noted in 16 hips (12.3%), seven of which (44%) underwent supplementary surgery and nine (56%) of which were classified as satisfactory. The acetabular index was the most reliable predictor of residual acetabular dysplasia.
Nakamura
J
J
Department of Orthopaedic Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, 260-8677, Japan. njonedr@yahoo.co.jp
Kamegaya
M
M
Saisu
T
T
Someya
M
M
Koizumi
W
W
Moriya
H
H
D002985:Clinical Protocols; D005260:Female; D005271:Femur Head Necrosis / Q000209:etiology; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D009989:Orthotic Devices / Q000009:adverse effects; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome