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Pubmed for Handhelds

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  • Title: Effectiveness of Mom-made Pavlik harness for maintaining reduction of the hip in DDH.
    Author: Lewsirirat S, Piyapromdee U, Sathompanich S.
    Journal: J Med Assoc Thai; 2015 Jan; 98(1):53-8. PubMed ID: 25775732.
    Abstract:
    BACKGROUND: Co-operation of the parent is a major factor for successful treatment of developmental dysplasia of the hip (DDH). The commercial Pavlik harness is too expensive and the parent may not understand or refuse its use. Regarding the function of the Pavlik harness and awareness of complications, a Mom-made Pavlik harness was developed. OBJECTIVE: To evaluate the effectiveness of Mom-made Pavlik harness in maintaining the reduction ofDDH MATERIAL AND METHOD: Infants with Ortolani positive DDH, ages up to five months, treated at Maharat Nakhon Ratchasima Hospital between October 2003 and September 2012, were analyzed, retrospectively. Irreducible DDH, neuromuscular DDH and hyperlaxity syndrome were excluded. A Mom-made Pavlik harness was used to maintain reduction after the initial two weeks of a hip spica cast. The success of treatment was evaluated by ultrasound of the hip. The center edge (CE) angle was measured from AP film at age one and four years. RESULTS: There were 24 infants, 35 hips with 11 bilateral, seven left and six right sides DDH. Thirty-two hips were successfully reduced (91.4%). Three hips had recurrent dislocation. Two of these were further managed by adductor tenotomy and closed reduction under general anesthesia and hip spica cast, followed by hip abduction brace. Another was treated by open reduction and Salter's innominate osteotomy. The average CE angle at age one and four years was 16.5 and 25.9 degree, respectively. CONCLUSION: Treatment of the infants with DDH requires a long period of care not only in hospital but also at home. Therefore, it needs the diligence, intention and regularity by their parents to achieve a successful outcome. The Mom-made Pavlik harness represents the spirit of this resolution.
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