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An unstable hip is one that is either already dislocated (out of the socket) or can be dislocated by the doctor when examining the child. Several hands-on tests can be done to determine whether or not a hip is stable or unstable.
The Pavlik harness is used most often to treat hip instability in young children. It is designed to keep the hip in a position of flexion and abduction (legs apart). This position keeps the ball (the femoral head) in the best position and allows the ligaments and joint capsule to tighten up.
The goal of treatment 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 proper hip position must be maintained for enough time to stabilize the joint.
The harness is usually worn until the doctor can no longer move the hip in and out of the socket. In the older child, x-rays may be used to confirm that the hip is stable. Ultrasound scanning has also been shown effective in keeping track of the hip's progress.
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