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We have suddenly become "parents" again taking care of our 10-month old granddaughter who has been abandoned by her mother. We took her to the pediatrician and found out she has hip dysplasia that was never treated as a baby. The doctor thought it would be worth trying a harness for a few weeks but we found some information on the Internet that says the harness doesn't work in older babies. What do you think?
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For 50 years, children born with developmental dysplasia of the hip (DDH) have been treated successfully with the Pavlik harness. Most studies show that the earlier the treatment, the better the results.
The goal of treatment with the harness is to keep the femoral head in good contact with the acetabulum. A stable hip encourages the development of a normally shaped socket and rounded head of the femur. The hip should be flexed to 95 degrees and abducted (apart) at least 90 degrees. This position keeps the ball (the femoral head) in the best position and allows the ligaments and joint capsule to tighten up.
As you saw from your Internet search, the Pavlik harness is not usually recommended for older infants (six months of age or older). But the results of a recent study may suggest differently. Twenty-four children between the ages of nine months and 23 months (almost two years old) were placed in the Pavlik harness despite the late diagnosis.
Almost half (46 per cent) had a successful result and did not need any additional surgery. Results were obtained in the first six weeks if the harness was going to work. The harness was augmented by a dynamic abduction splint in about half of the group. But the results were not any better with the dynamic abduction splint than without. Children with the most severe dysplasia did not respond to the harness. Surgery was still required for them.
The Pavlik harness can be used successfully to treat developmental dysplsia of the hip with carefully selected older infants and children. A delayed diagnosis is not always an immediate passport to surgery. Surgery can be delayed by six weeks to see if the harness will work in older children. If the harness fails, then surgery can be done.
You may want to have your granddaughter evaluated by an orthopedic surgeon to find out how severe is her condition and whether a six-week delay would be okay while you try the harness.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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