The efficacy of pavlik harness as a treatment of developmental dislocation of the hip

Abstract EN

Objective : to evaluate the efficacy of using a Pavlik harness Orthosis in reducing dislocated hips in patients with developmental dislocation of the hip.

Methods : this is a prospective study done on patients who visited the pediatric orthopedics clinic in the Royal Medical Services in the period between October 2010 and June 2015.

Each patient diagnosed by radiography and fulfilled the inclusion criteria was examined prior to the application of a dynamic flexion abduction orthosis (Pavlik Harness orthosis) and then the Orthosis application is checked by one of the authors whom are a senior consultant pediatric orthopedic surgeon and four pediatric orthopedic specialists.

After that, a follow up period of two weeks is given to those patients who present with a dislocated hip in the age between three to six months.

The patients were reevaluated after two weeks by clinical examination of both hips and by radiography while maintaining the Pavlik harness orthosis applied on the patient.

Results : in this study 133 patients had fulfilled the inclusion criteria.

The number of dislocated hips was 184.

We found that there were 82 patients 61.6% who presented with unilateral hip dislocation and 51 patients 38.4% who presented with bilateral hip dislocation.

Female:Male ratio of 6.4:1 .

128 hips 69.7% achieved reduction after the application of a pavlik harness orthosis at two weeks follow up.

And 56 hips 30.3% diagnosed as a case of failed hip reduction and underwent closed reduction under general anesthesia with or without Adductor tendon tenotomy and static hip spica cast application.

3 patients 2.2% developed femoral Nerve palsy that fully recovered after discontinuity of Orthosis application.

Conclusion : the use of Pavlik Harness Orthosis is an effective method of treating patients who present with a dislocated of hip in the age between three to six months.

The younger the patient the better the outcome.