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High Failure Rate of the Pavlik Harness in Dislocated Hips: Is It Bilaterality?

Palocaren, Thomas MBBS, MS(Orth)*; Rogers, Kenneth PhD, ATC*; Haumont, Thierry MD*; Grissom, Leslie MD; Thacker, Mihir M. MD*

Journal of Pediatric Orthopaedics: July/August 2013 - Volume 33 - Issue 5 - p 530–535
doi: 10.1097/BPO.0b013e318287ffc6

Background: The purpose of this study was to evaluate the efficacy of Pavlik harness treatment in patients with bilaterally dislocated Graf type IV hips and compare them to cases with unilaterally dislocated hips.

Methods: Twenty-one patients (42 hips) who presented with bilaterally dislocated hips with no prior treatment were studied. The comparison group consisted of 33 patients (33 hips) with unilateral hip dislocation treated with the same protocol. Successful treatment was defined as relocation of the hips within 3 weeks of Pavlik harness application.

Results: Twelve of 21 patients (57%) in the bilateral group (6 failed bilaterally, 6 unilaterally) and 18/33 patients (54.5%) in the unilateral group failed harness treatment.

Conclusions: The use of the Pavlik harness in dislocated hips is associated with a high failure rate. Patients presenting with bilaterally dislocated hips however, are at no greater risk for failure than patients presenting with unilateral hip dislocation.

Level of Evidence: Level III.

Departments of *Orthopedics, Nemours Children’s Clinic

Radiology, Alfred I. duPont Hospital for Children, Wilmington, DE

No sources of support were provided for this study.

IRB approval was granted for the retrospective review of medical charts.

The authors declare no conflict of interest.

Reprints: Mihir M. Thacker, MD, Department of Radiology, Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE 19899. E-mail:

© 2013 by Lippincott Williams & Wilkins