Pavlik Harness

Treatment of Hip Dysplasia In Babies

pavlik harness hip dysplasia
A baby wearing a Pavlik harness for treatment of hip dysplasia. Photo © Robin Elise Weiss, LCCE

A Pavlik harness is used in the treatment of hip dysplasia in infants.  Hip dysplasia is a condition that occurs in newborns, and caused abnormal formation of the hip joint.  The treatment of dysplasia is focused on restoring normal alignment of the hip joint so that the development can proceed normally.  The two keys of effective treatment of hip dysplasia are:

  1. Restoring normal hip joint alignment (reducing the hip)
  1. Keeping the hip joint stable (keeping the ball in the socket)

Your doctor will do what is necessary to accomplish these goals.  Depending on the decree of instability of the hip, the age of the child, and other factors, the treatment may different depending on the specific situation.  However, the most common treatment for hip dysplasia, especially in infants younger than 6 months old, is called a Pavlik harness.

Pavlik Harness

The Pavlik harness is fit to the baby and holds his or her hips in proper position. By flexing up the legs, and allowing the knees to fall outwards, the hips are held in proper position. By doing so, the hip joint is properly reduced, and the hips will form normally.

It is important to understand the proper use and fit of a Pavlik harness. A Pavlik harness that is too tight can do more damage to the baby's hips, and a Pavlik harness that is too loose will not hold the hips properly.

Babies who are fit for a Pavlik harness should be checked regularly to ensure proper fit of the device and to ensure the hips are being held in the proper position.  The harness is worn until the hip joint is stable without being in the brace.  The stability of the hip joint can be assessed either by a skilled examiner or by the use of an ultrasound test.

If the harness is worn on the child, and the hips do not return to the proper position in the hip socket within a few weeks or a month, the harness should be discontinued and an alternative treatment considered.  Alternative treatments may include the use of a rigid cast, called a hip spica, or surgical treatment.

Complications of a Pavlik Harness

A Pavlik harness is generally a very safe, and most often a very effective treatment for babies with hip dysplasia.  The most common problem is flexing (bending) the hips up too high, and sometimes causing nerve damage because of the excessive bend at the hip joints.  For this reason, it is important that parents be trained on proper use and adjustment of the harness.  The other concern is that some babies have developmental dysplasia that is not adequately treated by the harness.  These babies should have alternative treatments considered to ensure proper hip joint development.

Sources:

Guille JT, Pizzutillo PD, MacEwen GD "Developmental Dysplasia of the Hip From Birth to Six Months" J. Am. Acad. Ortho. Surg., July/August 2000; 8: 232 - 242.

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