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Title: Treatment of developmental dysplasia of the hip with the Pavlik harness in children under six months of age: indications, results and failures
Authors: Ömeroğlu, Hakan
Keywords: Developmental dysplasia of the hip
Pavlik harness
Issue Date: Aug-2018
Publisher: The British Editorial Society of Bone & Joint Surgery
Source: Ömeroglu, H. (2018). Treatment of developmental dysplasia of the hip with the Pavlik harness in children under six months of age: indications, results and failures. Journal of children's orthopaedics, 12(4), 308-316.
Abstract: Purpose The aim of this article is to review the current concepts in the indications, results and failure causes of the treatment of developmental dysplasia of the hip (DDH) with the Pavlik harness. Methods: The reported variables influencing the outcome in the Pavlik harness treatment were analyzed. Results Significant discrepancies about the clinical and radiological outcomes, the rates of failure and complications as well as the variables influencing the treatment outcome occur in the published studies due to the heterogeneity of the data and the differences in the methods used. The overall short-, mid- or long-term success rate of the treatment ranges from 45% to 100% and it is commonly over 75%. The rate of osteonecrosis of the femoral head ranges from 1% to 30%. Age, gender, laterality, radiological or clinical severity of the initial hip pathology and parents’ compliance are the commonly reported determinants of failure of the treatment. Conclusion The failure in treatment with the Pavlik harness is multifactorial, initial type of hip dysplasia being the most prominent followed by the treatment initiation age. This type of treatment cannot be considered as the best option in Graf IV hips (hip ultrasonography) or highly dislocated hips (plain radiography) and in infants older than three months of age, as the risk of failure and development of complications including osteonecrosis and femoral nerve palsy seem to increase in such circumstances. Large-scale, comparative studies including homogenous data are needed to answer the unsolved questions concerning indications.
Description: Paper submitted at the 37th EPOS Annual Meeting, Oslo, Norway, April 11-14, 2018 published in this Special Issue of J Child Orthop.
ISSN: 1863-2548
Appears in Collections:Cerrahi Tıp Bilimleri Bölümü / Department of Surgical Sciences
PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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