title: The success of management with the Pavlik harness for developmental dysplasia of the hip using a United Kingdom screening programme and ultrasound-guided supervision.
abstract: We present the results of treatment of developmental dysplasia of the hip in infancy with the Pavlik harness using a United Kingdom screening programme with ultrasound-guided supervision. Initially, 128 consecutive hips in 77 patients were reviewed over a 40-month period; 123 of these were finally included in the study. The mean age of the patients at the start of treatment was five weeks (1 to 12). All hips were examined clinically and monitored with ultrasound scanning. Failure of treatment was defined as an inability to maintain reduction with the harness. All hips diagnosed with dysplasia or subluxation but not dislocation were managed successfully in the harness. There were 43 dislocated hips, of which 39 were reducible, but six failed treatment in the harness. There were four dislocated but irreducible hips which all failed treatment in the harness. One hip appeared to be successfully treated in the harness but showed persistent radiological dysplasia at 12 and 24 months. Grade 1 avascular necrosis was identified radiologically in three patients at 12 months.
authors.affiliation: Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK. mikewalton@doctors.org.uk
authors.forename: M J
authors.initials: MJ
authors.lastname: Walton
authors.forename: Z
authors.initials: Z
authors.lastname: Isaacson
authors.forename: D
authors.initials: D
authors.lastname: McMillan
authors.forename: R
authors.initials: R
authors.lastname: Hawkes
authors.forename: W G
authors.initials: WG
authors.lastname: Atherton
mesh_terms: D004812:Epidemiologic Methods; D005271:Femur Head Necrosis / Q000209:etiology; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009989:Orthotic Devices / Q000009:adverse effects; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*