title: Successful Pavlik Harness Treatment for Developmental Dysplasia of the Hip and Normal X-Ray at the Age of 2 Years: Is a Longer Follow-up Necessary?
abstract: BACKGROUND
  Management of developmental dysplasia of the hip (DDH) with a Pavlik harness is a well-known treatment.Follow-up until skeletal maturity is recommended as long-term studies mention late sequelae.The purpose of this study was to determine whether such a follow-up is necessary in patients treated successfully under a strict protocol.
  
  
  METHODS
  A retrospective review of a consecutive series of normal infants treated for DDH between January 1995 and July 2004 was undertaken.Only normal infants with frankly pathologic hips treated successfully with a Pavlik harness were included, and with a normal anteroposterior (AP) pelvis x-ray at the age of 2 years.All infants with any type of neurological disease, syndrome, other form of treatment for DDH, and failure of the Pavlik harness were excluded.At the last follow-up, a clinical examination and a standing AP pelvis x-ray were performed.
  
  
  RESULTS
  A total of 109 hips in 83 children were available for review. The mean follow-up was of 10 years and 2 months. All 109 hips had a normal clinical examination and a normal AP pelvis x-ray: a mean center-edge angle (CEA) of 29.5 degrees, SD±4.1 degrees, a mean acetabular index (AI) of 1457±3.74 degrees, a mean Sharp's angle of 41.92±3.42 degrees, a Seringe-Severin score of IA, a normal teardrop figure, no signs of avascular necrosis, and Moses circles <2.
  
  
  CONCLUSIONS
  This study strongly suggests that in a selected group of patients treated for DDH with a Pavlik harness, under a strict protocol, and a normal x-ray at 2 years of age, a long-term follow-up is not necessary.
  
  
  METHODS
  Level III-therapeutic.
authors.affiliation: Department of Orthopaedics, Service de Chirurgie Orthopédique, CHR La Citadelle, Liège, Belgium.
authors.forename: Nanni J
authors.initials: NJ
authors.lastname: Allington
mesh_terms: D000359:Aftercare; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D009989:Orthotic Devices; D010388:Pelvis / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D014965:X-Rays