Meeran Farook Naji, Presenter: Nothing to Disclose

En Hsun Choi MBChB, Abstract Co-Author: Nothing to Disclose

Sally Wilkinson, Abstract Co-Author: Nothing to Disclose

Graham Wilkinson MBCHB, Abstract Co-Author: Nothing to Disclose

The Pavlik harness is widely used in infants with developmental dysplasia of the hip (DDH) but there is conflicting evidence as to when treatment should commence. The aim of our study is to determine the treatment outcome and its correlation with age when treatment started.

We retrospectively reviewed data for all babies treated with Pavlik harness over a four-year period. The diseased hips of these babies were divided into two groups: in group A treatment started aged 8 weeks or under and in group B over 8 weeks. Outcome was defined radiologically by grading radiographs taken about 1 year of age as normal, mild dysplasia (deficiency of the acetabular margin only), moderate dysplasia (abnormality of the roof) or severe dysplasia (subluxation of the hip).

137 hips in 102 babies (89 girls and 13 boys) with DDH treated with the Pavlik harness were included in the study. The disease was bilateral in 35 babies and unilateral in 67. Satisfactory outcome (normal or mild dysplasia) was achieved in 108 of the 109 hips (99%) in group A compared to 19 of the 28 (68%) in group B (p<0.001).

This study showed that in our institution satisfactory outcome of DDH treated with Pavlik harness is achieved in almost all cases if treatment is commenced before 8 weeks of age.

It is imperative that detection and referral procedures allow harness application by 8 weeks to obviate invasive and potentially less effective treatments.

Naji, M, Choi, E, Wilkinson, S, Wilkinson, G, The Correlation between the Treatment Outcome of Developmental Dysplasia of the Hip (DDH) with Pavlik Harness and the Age When Treatment Started.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5007900.html