Prolonged treatment with the Pavlik harness in infants with developmental dysplasia of the hip
We prospectively studied the benefits and risks of prolonged treatment with the Pavlik harness in infants with idiopathic developmental dysplasia of the hip. Bracing was continued as long as abduction improved. It was started at a mean age of four months (1 to 6.9). Outcome measures were the number...
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| Veröffentlicht in: | Journal of bone and joint surgery. British volume 2009-08, Vol.91 (8), p.1090-1093 |
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| container_title | Journal of bone and joint surgery. British volume |
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| creator | VAN DER SLUIJS, J. A DE GIER, L VERBEKE, J. I WITBREUK, M. M. E. H PRUYS, J. E. H VAN ROYEN, B. J |
| description | We prospectively studied the benefits and risks of prolonged treatment with the Pavlik harness in infants with idiopathic developmental dysplasia of the hip. Bracing was continued as long as abduction improved. It was started at a mean age of four months (1 to 6.9). Outcome measures were the number of successful reductions, the time to reduction, the acetabular index and evidence of avascular necrosis at follow-up at one year. In 50 infants with 62 subluxated and dislocated hips (42 Graf type III and 20 type IV), 37 were reduced successfully with a mean time to reduction of 13.4 weeks (sd 6.8). Bracing was successful in 31 type-III (73.8%) and in only six type-IV hips (20%, p = 0.002). Avascular necrosis was seen in ten hips. Prolonged treatment with the Pavlik harness for developmental dysplasia of the hip over the age of one month can be beneficial in type-III hips, but it is unclear as to whether this is the optimal treatment, since it may postpone the need for closed or open reduction to a more unfavourable age. The use of the Pavlik harness in type-IV hips in this age group is questionable, but if used, prolonged bracing is not advised. |
| doi_str_mv | 10.1302/0301-620X.91B8.21692 |
| format | Article |
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A ; DE GIER, L ; VERBEKE, J. I ; WITBREUK, M. M. E. H ; PRUYS, J. E. H ; VAN ROYEN, B. J</creator><creatorcontrib>VAN DER SLUIJS, J. A ; DE GIER, L ; VERBEKE, J. I ; WITBREUK, M. M. E. H ; PRUYS, J. E. H ; VAN ROYEN, B. J</creatorcontrib><description>We prospectively studied the benefits and risks of prolonged treatment with the Pavlik harness in infants with idiopathic developmental dysplasia of the hip. Bracing was continued as long as abduction improved. It was started at a mean age of four months (1 to 6.9). Outcome measures were the number of successful reductions, the time to reduction, the acetabular index and evidence of avascular necrosis at follow-up at one year. In 50 infants with 62 subluxated and dislocated hips (42 Graf type III and 20 type IV), 37 were reduced successfully with a mean time to reduction of 13.4 weeks (sd 6.8). Bracing was successful in 31 type-III (73.8%) and in only six type-IV hips (20%, p = 0.002). Avascular necrosis was seen in ten hips. Prolonged treatment with the Pavlik harness for developmental dysplasia of the hip over the age of one month can be beneficial in type-III hips, but it is unclear as to whether this is the optimal treatment, since it may postpone the need for closed or open reduction to a more unfavourable age. The use of the Pavlik harness in type-IV hips in this age group is questionable, but if used, prolonged bracing is not advised.</description><edition>British volume</edition><identifier>ISSN: 0301-620X</identifier><identifier>ISSN: 2049-4394</identifier><identifier>EISSN: 2044-5377</identifier><identifier>EISSN: 2049-4408</identifier><identifier>DOI: 10.1302/0301-620X.91B8.21692</identifier><identifier>PMID: 19651841</identifier><identifier>CODEN: JBSUAK</identifier><language>eng</language><publisher>London: British Editorial Society of Bone and Joint Surgery</publisher><subject>Acetabulum - abnormalities ; Acetabulum - diagnostic imaging ; Biological and medical sciences ; Braces ; Diseases of the osteoarticular system ; Female ; Femur Head Necrosis - diagnostic imaging ; Femur Head Necrosis - therapy ; Hip Dislocation, Congenital - diagnostic imaging ; Hip Dislocation, Congenital - therapy ; Humans ; Infant ; Malformations and congenital and or hereditary diseases involving bones. Joint deformations ; Medical sciences ; Orthopedic surgery ; Prospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Time Factors ; Treatment Outcome ; Ultrasonography ; Weight-Bearing</subject><ispartof>Journal of bone and joint surgery. British volume, 2009-08, Vol.91 (8), p.1090-1093</ispartof><rights>2009 INIST-CNRS</rights><rights>Copyright British Editorial Society of Bone & Joint Surgery Aug 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-b2f01ca16046b4d9b5e749ba93dde2d122ca474dfa64cf342871656e3d3bb15e3</citedby><cites>FETCH-LOGICAL-c439t-b2f01ca16046b4d9b5e749ba93dde2d122ca474dfa64cf342871656e3d3bb15e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21781959$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19651841$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>VAN DER SLUIJS, J. A</creatorcontrib><creatorcontrib>DE GIER, L</creatorcontrib><creatorcontrib>VERBEKE, J. I</creatorcontrib><creatorcontrib>WITBREUK, M. M. E. H</creatorcontrib><creatorcontrib>PRUYS, J. E. H</creatorcontrib><creatorcontrib>VAN ROYEN, B. J</creatorcontrib><title>Prolonged treatment with the Pavlik harness in infants with developmental dysplasia of the hip</title><title>Journal of bone and joint surgery. British volume</title><addtitle>J Bone Joint Surg Br</addtitle><description>We prospectively studied the benefits and risks of prolonged treatment with the Pavlik harness in infants with idiopathic developmental dysplasia of the hip. Bracing was continued as long as abduction improved. It was started at a mean age of four months (1 to 6.9). Outcome measures were the number of successful reductions, the time to reduction, the acetabular index and evidence of avascular necrosis at follow-up at one year. In 50 infants with 62 subluxated and dislocated hips (42 Graf type III and 20 type IV), 37 were reduced successfully with a mean time to reduction of 13.4 weeks (sd 6.8). Bracing was successful in 31 type-III (73.8%) and in only six type-IV hips (20%, p = 0.002). Avascular necrosis was seen in ten hips. Prolonged treatment with the Pavlik harness for developmental dysplasia of the hip over the age of one month can be beneficial in type-III hips, but it is unclear as to whether this is the optimal treatment, since it may postpone the need for closed or open reduction to a more unfavourable age. The use of the Pavlik harness in type-IV hips in this age group is questionable, but if used, prolonged bracing is not advised.</description><subject>Acetabulum - abnormalities</subject><subject>Acetabulum - diagnostic imaging</subject><subject>Biological and medical sciences</subject><subject>Braces</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Femur Head Necrosis - diagnostic imaging</subject><subject>Femur Head Necrosis - therapy</subject><subject>Hip Dislocation, Congenital - diagnostic imaging</subject><subject>Hip Dislocation, Congenital - therapy</subject><subject>Humans</subject><subject>Infant</subject><subject>Malformations and congenital and or hereditary diseases involving bones. Joint deformations</subject><subject>Medical sciences</subject><subject>Orthopedic surgery</subject><subject>Prospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ultrasonography</subject><subject>Weight-Bearing</subject><issn>0301-620X</issn><issn>2049-4394</issn><issn>2044-5377</issn><issn>2049-4408</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0U9rFDEYx_EgFrutvgORQdDbbPPk7-Roi1ahYA8VPBmemTzjTs3OjMlspe_eme5SoRchkMvnFwhfxl4DX4Pk4oxLDqUR_PvawXm1FmCceMZWgitVamntc7Z6JMfsJOdbzrnSWr5gx-CMhkrBiv24TkMc-p8UiikRTlvqp-JPN22KaUPFNd7F7lexwdRTzkXXz6fFfsp7EuiO4jAuG4xFuM9jxNxhMbQP6003vmRHLcZMrw73Kfv26ePNxefy6uvll4sPV2WjpJvKWrQcGgTDlalVcLUmq1yNToZAIoAQDSqrQotGNa1UorJgtCEZZF2DJnnK3u_fHdPwe0d58tsuNxQj9jTssjdWa1FJ9V8ouDNgdTXDt0_g7bBL_fwJL4Qz1mmrZ6T2qElDzolaP6Zui-neA_dLJb8k8EsCv1TyD5Xm2ZvD27t6S-Hf6JBlBu8OAHODsU3YN11-dAJsBU47-RcQIpqU</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>VAN DER SLUIJS, J. A</creator><creator>DE GIER, L</creator><creator>VERBEKE, J. I</creator><creator>WITBREUK, M. M. E. H</creator><creator>PRUYS, J. E. H</creator><creator>VAN ROYEN, B. J</creator><general>British Editorial Society of Bone and Joint Surgery</general><general>British Editorial Society of Bone & Joint Surgery</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>20090801</creationdate><title>Prolonged treatment with the Pavlik harness in infants with developmental dysplasia of the hip</title><author>VAN DER SLUIJS, J. A ; DE GIER, L ; VERBEKE, J. I ; WITBREUK, M. M. E. H ; PRUYS, J. E. H ; VAN ROYEN, B. J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-b2f01ca16046b4d9b5e749ba93dde2d122ca474dfa64cf342871656e3d3bb15e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acetabulum - abnormalities</topic><topic>Acetabulum - diagnostic imaging</topic><topic>Biological and medical sciences</topic><topic>Braces</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Femur Head Necrosis - diagnostic imaging</topic><topic>Femur Head Necrosis - therapy</topic><topic>Hip Dislocation, Congenital - diagnostic imaging</topic><topic>Hip Dislocation, Congenital - therapy</topic><topic>Humans</topic><topic>Infant</topic><topic>Malformations and congenital and or hereditary diseases involving bones. Joint deformations</topic><topic>Medical sciences</topic><topic>Orthopedic surgery</topic><topic>Prospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ultrasonography</topic><topic>Weight-Bearing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>VAN DER SLUIJS, J. A</creatorcontrib><creatorcontrib>DE GIER, L</creatorcontrib><creatorcontrib>VERBEKE, J. I</creatorcontrib><creatorcontrib>WITBREUK, M. M. E. H</creatorcontrib><creatorcontrib>PRUYS, J. E. H</creatorcontrib><creatorcontrib>VAN ROYEN, B. 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J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prolonged treatment with the Pavlik harness in infants with developmental dysplasia of the hip</atitle><jtitle>Journal of bone and joint surgery. British volume</jtitle><addtitle>J Bone Joint Surg Br</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>91</volume><issue>8</issue><spage>1090</spage><epage>1093</epage><pages>1090-1093</pages><issn>0301-620X</issn><issn>2049-4394</issn><eissn>2044-5377</eissn><eissn>2049-4408</eissn><coden>JBSUAK</coden><abstract>We prospectively studied the benefits and risks of prolonged treatment with the Pavlik harness in infants with idiopathic developmental dysplasia of the hip. Bracing was continued as long as abduction improved. It was started at a mean age of four months (1 to 6.9). Outcome measures were the number of successful reductions, the time to reduction, the acetabular index and evidence of avascular necrosis at follow-up at one year. In 50 infants with 62 subluxated and dislocated hips (42 Graf type III and 20 type IV), 37 were reduced successfully with a mean time to reduction of 13.4 weeks (sd 6.8). Bracing was successful in 31 type-III (73.8%) and in only six type-IV hips (20%, p = 0.002). Avascular necrosis was seen in ten hips. Prolonged treatment with the Pavlik harness for developmental dysplasia of the hip over the age of one month can be beneficial in type-III hips, but it is unclear as to whether this is the optimal treatment, since it may postpone the need for closed or open reduction to a more unfavourable age. The use of the Pavlik harness in type-IV hips in this age group is questionable, but if used, prolonged bracing is not advised.</abstract><cop>London</cop><pub>British Editorial Society of Bone and Joint Surgery</pub><pmid>19651841</pmid><doi>10.1302/0301-620X.91B8.21692</doi><tpages>4</tpages><edition>British volume</edition><oa>free_for_read</oa></addata></record> |
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| subjects | Acetabulum - abnormalities Acetabulum - diagnostic imaging Biological and medical sciences Braces Diseases of the osteoarticular system Female Femur Head Necrosis - diagnostic imaging Femur Head Necrosis - therapy Hip Dislocation, Congenital - diagnostic imaging Hip Dislocation, Congenital - therapy Humans Infant Malformations and congenital and or hereditary diseases involving bones. Joint deformations Medical sciences Orthopedic surgery Prospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Time Factors Treatment Outcome Ultrasonography Weight-Bearing |
| title | Prolonged treatment with the Pavlik harness in infants with developmental dysplasia of the hip |
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