Discussion:
- Pavlik harness is a dynamic flexion abduction orthosis used to treat DDH in infants up to 6 months of age;
- harness usually leads to stability of reduced hip w/ in 4 wks, but its use should be continued until clinical exam & x-rays
of hip are normal;
- patient's should expect a 85-95% success rate if the diagnosis is made in the newborn nursery;
- clearly, a lower success rate would be expected w/ a teratologic dislocation;
- indications and contra-indications:
- indicated for infants w/ DDH & who are younger than six months;
- not indicated for infants w/ a "hip click" but a normal physical exam (Barlow's test and Ortolani's test);
- if teratologic dislocation is present, Pavlik harness is not used;
- cautions:
- note that continued dislocation of a hip while in Pavlik harness stretches the posterior capsule and reduces chances of
maintaining good reduction later;
- note that male patients and patients w/ bilateral dislocations may have worse results w/ the Pavlik harness than females;
- it is difficult to determine the true success rate for patients w/ clear cut DDH, since results published from tertiary care centers
will be biased due to the large number of referred cases (referred because of treatment failures);
- other negative risk factors include: DDH in children older than 7 weeks, and hips which are not initially reducible;
- age greater than 6 mo is a contraindication due to worsening of impediments to reduction;
- in these pts, harness may not produce reliabe reduction; pavlik
pavlik harness application, pavlik harness indications, pavlik harness technique, pavlik harness how to apply,pavlik harness application, pavlik harness indications, pavlik harness technique, pavlik harness how to apply
- Pavlik harness is a dynamic flexion abduction orthosis used to treat DDH in infants up to 6 months of age;
- harness usually leads to stability of reduced hip w/ in 4 wks, but its use should be continued until clinical exam & x-rays
of hip are normal;
- patient's should expect a 85-95% success rate if the diagnosis is made in the newborn nursery;
- clearly, a lower success rate would be expected w/ a teratologic dislocation;
- indications and contra-indications:
- indicated for infants w/ DDH & who are younger than six months;
- not indicated for infants w/ a "hip click" but a normal physical exam (Barlow's test and Ortolani's test);
- if teratologic dislocation is present, Pavlik harness is not used;
- cautions:
- note that continued dislocation of a hip while in Pavlik harness stretches the posterior capsule and reduces chances of
maintaining good reduction later;
- note that male patients and patients w/ bilateral dislocations may have worse results w/ the Pavlik harness than females;
- it is difficult to determine the true success rate for patients w/ clear cut DDH, since results published from tertiary care centers
will be biased due to the large number of referred cases (referred because of treatment failures);
- other negative risk factors include: DDH in children older than 7 weeks, and hips which are not initially reducible;
- age greater than 6 mo is a contraindication due to worsening of impediments to reduction;
- in these pts, harness may not produce reliabe reduction; pavlik
pavlik harness application, pavlik harness indications, pavlik harness technique, pavlik harness how to apply,pavlik harness application, pavlik harness indications, pavlik harness technique, pavlik harness how to apply
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