title: High failure rate of the Pavlik harness in dislocated hips: is it bilaterality?
abstract: BACKGROUND
  The purpose of this study was to evaluate the efficacy of Pavlik harness treatment in patients with bilaterally dislocated Graf type IV hips and compare them to cases with unilaterally dislocated hips.
  
  
  METHODS
  Twenty-one patients (42 hips) who presented with bilaterally dislocated hips with no prior treatment were studied. The comparison group consisted of 33 patients (33 hips) with unilateral hip dislocation treated with the same protocol. Successful treatment was defined as relocation of the hips within 3 weeks of Pavlik harness application.
  
  
  RESULTS
  Twelve of 21 patients (57%) in the bilateral group (6 failed bilaterally, 6 unilaterally) and 18/33 patients (54.5%) in the unilateral group failed harness treatment.
  
  
  CONCLUSIONS
  The use of the Pavlik harness in dislocated hips is associated with a high failure rate. Patients presenting with bilaterally dislocated hips however, are at no greater risk for failure than patients presenting with unilateral hip dislocation.
  
  
  METHODS
  Level III.
authors.affiliation: Department of Orthopedics, Nemours Children's Clinic, Wilmington, DE, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Palocaren
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rogers
authors.forename: Thierry
authors.initials: T
authors.lastname: Haumont
authors.forename: Leslie
authors.initials: L
authors.lastname: Grissom
authors.forename: Mihir M
authors.initials: MM
authors.lastname: Thacker
mesh_terms: D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009989:Orthotic Devices; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome