ASSESSMENT OF PAVLIK HARNESS EFFECTIVENESS IN 3-6 MONTHS OLD PATIENTS WITH UNSTABLE HIPS

Abstract

Objective: To investigate the effectiveness of the Pavlik harness (PH) in the treatment of patients who were diagnosed with unstable hips aged between three and six months. Material and Method: We retrospectively reviewed patients aged three to six months who were diagnosed with unstable hips and treated with the PH. The patients were treated using PH and were closely followed by a weekly clinical examination. The primary outcome was to assess the success rate of PH treatment in children with unstable hips (Graf Type IID, III, IV). A successful outcome as a result of PH treatment was defined as either obtaining a Type I hip based on Graf’s method of hip ultrasonography or a concentric reduction based on hip radiography. Results: Thirty-three patients’ 34 hips were included in this study with a diagnosis of DDH based on hip sonography performed according to the Graf’s method at the time of initial admission to our department. The mean age of the children in the beginning of the PH treatment was 17 weeks (range, 14–22); the mean follow-up was 48 months (range, 24–84). On admission, the mean alpha angle was 46 (range, 35–58). According to the Graf classification, DDH was determined as Type D in 18 hips (52%), Type IIIa in 5 hips, Type IIIB in 3 (24%) and Type IV in 8 (24%). Of these 34 hips, 28 (82%) were treated successfully using PH, with a mean application time of 11.24 weeks (range, 4–20). The success rate of PH treatment was determined as 82% (28/34 hips). Conclusions: Favorable outcomes can be expected from PH treatment in patients with unstable hips (Graf Type IID, III, IV) who are diagnosed between the age of three and six months.