Use of the Pavlik harness in congenital dislocation of the hip. An analysis of failures of treatment

R. G. Viere, J. G. Birch, J. A. Herring, J. W. Roach, C. E. Johnston

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

In twenty-five patients, the Pavlik harness failed to obtain or maintain reduction in thirty of thirty-five congenital dislocations of the hip. All of the patients had met the clinical criteria for use of the harness in our institution: they were less than seven months old, the femoral head pointed to the triradiate cartilage on anteroposterior radiographs that were made with the child wearing the harness, and they had no evidence of neuromuscular disease or teratological dislocation. These patients were compared with seventy-one patients (eighty-one dislocations) who had also been treated with the Pavlik harness and in whom a stable reduction was obtained and maintained. Statistically significant risk factors for failure of the harness included an absent Ortolani sign at the initial evaluation, bilateral dislocation, and an age of more than seven weeks before treatment with the harness was begun. All thirty hips in which the harness failed to obtain or maintain reduction had a subsequent attempt at closed reduction after preliminary Bryant traction. Fifteen of these hips were successfully reduced closed, but two later redislocated and needed an open reduction. The remaining fifteen hips needed an open reduction, and two redislocated and needed a second open reduction.

Original languageEnglish (US)
Pages (from-to)238-234
Number of pages5
JournalJournal of Bone and Joint Surgery - Series A
Volume72
Issue number2
StatePublished - 1990

Fingerprint

Congenital Hip Dislocation
Treatment Failure
Hip
Neuromuscular Diseases
Traction
Thigh
Cartilage
Therapeutics

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Use of the Pavlik harness in congenital dislocation of the hip. An analysis of failures of treatment. / Viere, R. G.; Birch, J. G.; Herring, J. A.; Roach, J. W.; Johnston, C. E.

In: Journal of Bone and Joint Surgery - Series A, Vol. 72, No. 2, 1990, p. 238-234.

Research output: Contribution to journalArticle

@article{c8bde32d19124f7a8f18e40c7e6823d3,
title = "Use of the Pavlik harness in congenital dislocation of the hip. An analysis of failures of treatment",
abstract = "In twenty-five patients, the Pavlik harness failed to obtain or maintain reduction in thirty of thirty-five congenital dislocations of the hip. All of the patients had met the clinical criteria for use of the harness in our institution: they were less than seven months old, the femoral head pointed to the triradiate cartilage on anteroposterior radiographs that were made with the child wearing the harness, and they had no evidence of neuromuscular disease or teratological dislocation. These patients were compared with seventy-one patients (eighty-one dislocations) who had also been treated with the Pavlik harness and in whom a stable reduction was obtained and maintained. Statistically significant risk factors for failure of the harness included an absent Ortolani sign at the initial evaluation, bilateral dislocation, and an age of more than seven weeks before treatment with the harness was begun. All thirty hips in which the harness failed to obtain or maintain reduction had a subsequent attempt at closed reduction after preliminary Bryant traction. Fifteen of these hips were successfully reduced closed, but two later redislocated and needed an open reduction. The remaining fifteen hips needed an open reduction, and two redislocated and needed a second open reduction.",
author = "Viere, {R. G.} and Birch, {J. G.} and Herring, {J. A.} and Roach, {J. W.} and Johnston, {C. E.}",
year = "1990",
language = "English (US)",
volume = "72",
pages = "238--234",
journal = "Journal of Bone and Joint Surgery - American Volume",
issn = "0021-9355",
publisher = "Journal of Bone and Joint Surgery Inc.",
number = "2",

}

TY - JOUR

T1 - Use of the Pavlik harness in congenital dislocation of the hip. An analysis of failures of treatment

AU - Viere, R. G.

AU - Birch, J. G.

AU - Herring, J. A.

AU - Roach, J. W.

AU - Johnston, C. E.

PY - 1990

Y1 - 1990

N2 - In twenty-five patients, the Pavlik harness failed to obtain or maintain reduction in thirty of thirty-five congenital dislocations of the hip. All of the patients had met the clinical criteria for use of the harness in our institution: they were less than seven months old, the femoral head pointed to the triradiate cartilage on anteroposterior radiographs that were made with the child wearing the harness, and they had no evidence of neuromuscular disease or teratological dislocation. These patients were compared with seventy-one patients (eighty-one dislocations) who had also been treated with the Pavlik harness and in whom a stable reduction was obtained and maintained. Statistically significant risk factors for failure of the harness included an absent Ortolani sign at the initial evaluation, bilateral dislocation, and an age of more than seven weeks before treatment with the harness was begun. All thirty hips in which the harness failed to obtain or maintain reduction had a subsequent attempt at closed reduction after preliminary Bryant traction. Fifteen of these hips were successfully reduced closed, but two later redislocated and needed an open reduction. The remaining fifteen hips needed an open reduction, and two redislocated and needed a second open reduction.

AB - In twenty-five patients, the Pavlik harness failed to obtain or maintain reduction in thirty of thirty-five congenital dislocations of the hip. All of the patients had met the clinical criteria for use of the harness in our institution: they were less than seven months old, the femoral head pointed to the triradiate cartilage on anteroposterior radiographs that were made with the child wearing the harness, and they had no evidence of neuromuscular disease or teratological dislocation. These patients were compared with seventy-one patients (eighty-one dislocations) who had also been treated with the Pavlik harness and in whom a stable reduction was obtained and maintained. Statistically significant risk factors for failure of the harness included an absent Ortolani sign at the initial evaluation, bilateral dislocation, and an age of more than seven weeks before treatment with the harness was begun. All thirty hips in which the harness failed to obtain or maintain reduction had a subsequent attempt at closed reduction after preliminary Bryant traction. Fifteen of these hips were successfully reduced closed, but two later redislocated and needed an open reduction. The remaining fifteen hips needed an open reduction, and two redislocated and needed a second open reduction.

UR - http://www.scopus.com/inward/record.url?scp=0025373993&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025373993&partnerID=8YFLogxK

M3 - Article

C2 - 2303510

AN - SCOPUS:0025373993

VL - 72

SP - 238

EP - 234

JO - Journal of Bone and Joint Surgery - American Volume

JF - Journal of Bone and Joint Surgery - American Volume

SN - 0021-9355

IS - 2

ER -