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Sonographic Monitoring of the Treatment of Developmental Disturbances of the Hip by the Pavlik Harness
- Source :
- Journal of Pediatric Orthopaedics B. 7:144-149
- Publication Year :
- 1998
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 1998.
-
Abstract
- This study was undertaken to verify the efficacy of the Pavlik harness in the treatment of developmental disturbances of the hip (DDH) when reduction and stabilization of the hip and conclusion of the treatment are monitored by sonography. With active mother participation, under direct supervision of one consistent orthopaedist, 547 patients (60 with 91 unstable hips; 196 with 232 dysplastic hips, types IIb, IIc, and D; and 291 with 376 dislocated hips types IIIa, IIIb, and IV), with an average age of 2.3 months were evaluated. The initial hip flexion in the harness was 60 degrees to 70 degrees, which was adjusted frequently until concentric hip reduction. Sonographic reduction was achieved in 89.7% of the hips in 2 weeks, in 8.3% in 3 weeks, and in 2% in 4 weeks. Sonographic hip stabilization was achieved in 87.4% in 4 weeks, in 9.8% in 5 weeks, and in 2.9% in 6 weeks. Soft tissue landmarks (the cartilaginous roof angle and capsule) were used for assessment of reduction and stabilization, but for conclusion of the treatment, bony roof angle was used as well. Fulltime harness treatment averaged 2.7 months for the whole group (1.4 months for unstable hips, 2.3 months for dysplastic hips, and 3 months for dislocated hips). The harness was abandoned in five patients, four because of mother noncompliance and one because of abdominal surgery. Other serious complications, including avascular necrosis (AVN), did not occur in this study. It was concluded that paying attention to the minute details of treatment with active engagement of the mother in the form of group therapy under direct and consistent supervision of one orthopaedist coupled with sonographic monitoring can ensure satisfactory outcome with a shorter period of treatment in a very high percentage of the cases.
- Subjects :
- Male
musculoskeletal diseases
medicine.medical_specialty
medicine.medical_treatment
Active engagement
Avascular necrosis
Dislocated hips
medicine
Humans
Orthopedics and Sports Medicine
Pavlik harness
Hip Dislocation, Congenital
Reduction (orthopedic surgery)
Retrospective Studies
Ultrasonography
Braces
business.industry
Infant, Newborn
Infant
Soft tissue
medicine.disease
Surgery
Treatment Outcome
Pediatrics, Perinatology and Child Health
Female
business
Hip flexion
Abdominal surgery
Subjects
Details
- ISSN :
- 1060152X
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Orthopaedics B
- Accession number :
- edsair.doi.dedup.....c1083e0c0fe4ef4a6ea05eb5b285a6a6