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Pavlik harness

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https://www.readbyqxmd.com/read/29126427/a-murine-model-for-developmental-dysplasia-of-the-hip-ablation-of-cx3cr1-affects-acetabular-morphology-and-gait
#1
George Feldman, Arlene Offemaria, Hind Sawan, Javad Parvizi, Theresa A Freeman
BACKGROUND: Developmental dysplasia of the hip (DDH) is a debilitating condition whose distinguishing signs include incomplete formation of the acetabulum leading to dislocation of the femur, accelerated wear of the articular cartilage and joint laxity resulting in osteoarthritis. It is a complex disorder having environmental and genetic causes. Existing techniques fail to detect milder forms of DDH in newborns leading to hip osteoarthritis in young adults. A sensitive, specific and cost effective test would allow identification of newborns that could be non-invasively corrected by the use of a Pavlik harness...
November 10, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29125399/an-analysis-of-variables-affecting-the-duration-of-pavlik-harness-treatment-is-it-possible-to-predict-the-duration-of-treatment
#2
Ahmet Salduz, Mehmet Demirel, Turgut Akgül, Fuat Bilgili
BACKGROUND: Pavlik harness is the initial treatment for the infants with developmental dysplasia of the hip who have not yet begun walking. OBJECTIVES: The present study evaluates the variables which affect the duration of PH treatment for patients successfully treated. STUDY DESIGN: Cross-sectional study. METHODS: Pavlik harness was employed for 140 hips of 87 patients with developmental dysplasia of the hip in our institution between 2010 and 2013...
November 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29080986/use-of-the-t%C3%A3-bingen-splint-for-the-initial-management-of-severely-dysplastic-and-unstable-hips-in-newborns-with-ddh-an-alternative-to-fettweis-plaster-and-pavlik-harness
#3
Hannes Kubo, Hakan Pilge, Kristina Weimann-Stahlschmidt, Karoline Stefanovska, Bettina Westhoff, Ruediger Krauspe
AIM: Hip dysplasia is one of the most common skeletal disorders. As a late consequence 20-25% of the patients are at risk to develop secondary osteoarthritis and may require total hip replacement early in life. The treatment principles of hip dislocation are (1) concentric reposition, (2) retention, i.e., plaster in human post or Pavlik harness and (3) maturation in abduction flexion orthesis. The Tübingen splint was introduced as a further development of abduction devices for the treatment of (residual) hip dysplasia with stable hips...
October 28, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29053500/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-femoral-shaft-fracture-pearls-and-pitfalls
#4
J Eric Gordon, Charles T Mehlman
Pediatric femoral shaft fractures present many challenging patient care decisions. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention is commonplace in virtually all older children. Treatment is determined primarily by patient age as modified by clinical factors including mechanism of injury, weight, and skeletal maturity. Infants can be successfully treated by placement into a Pavlik harness, whereas children younger than 5 years are most commonly treated by early reduction and spica cast immobilization...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28914664/three-dimensional-mri-analyses-of-prereduced-femoral-head-sphericity-in-patients-with-developmental-dysplasia-of-the-hip-after-pavlik-harness-failure
#5
Yuta Tsukagoshi, Hiroshi Kamada, Ryoko Takeuchi, Shogo Nakagawa, Yohei Tomaru, Makoto Kamegaya, Tomofumi Nishino, Yoshikazu Okamoto, Hajime Mishima, Masashi Yamazaki
We used three-dimensional (3D) MRI to assess the sphericity of the cartilaginous femoral head in developmental dysplasia of the hip. We assessed 21 children using 3D-MRI. The smallest sphere including the femoral head cartilage was drawn, the diameter was measured, and the center of the sphere was defined. We compared the diameters of the femoral heads between unaffected and diseased sides. The diameter of the affected side was smaller, with flattening at the posteromedial area and proximoposterior areas. 3D-MRI showed that the shape of the dislocated femoral head was aspherical with focal growth failure...
September 13, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28777280/a-comparison-of-pavlik-harness-treatment-regimens-for-dislocated-but-reducible-ortolani-hips-in-infantile-developmental-dysplasia-of-the-hip
#6
Adam C Hines, David C Neal, Terri Beckwith, ChanHee Jo, Harry K W Kim
BACKGROUND: Variation exists in the Pavlik harness (PH) treatment regimen for infantile developmental dysplasia of the hip (DDH). The purpose of this study was to determine if the daily PH wear duration (23 vs. 24 h) and frequency of follow-up visits affect the clinical and radiographic outcomes of infants with dislocated but reducible (Ortolani+) hips. METHODS: This study reviewed prospectively enrolled patients with DDH in a single center who presented at age <6 months with Ortolani+ hips and were treated with PH...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28659058/diagnosis-and-treatment-of-developmental-dysplasia-of-the-hip-a-current-practice-of-paediatric-orthopaedic-surgeons
#7
Rakan S Al-Essa, Fares H Aljahdali, Rakan M Alkhilaiwi, Winnie Philip, Ayman H Jawadi, Khalid I Khoshhal
BACKGROUND: Developmental dysplasia of the hip (DDH) is one of the prevalent musculoskeletal conditions in young adults and is a leading cause of hip osteoarthrosis in this age group. The optimum age for surgical intervention when needed is not well established in the literature and the lack of management guidelines and standard practice of DDH leads to different practices worldwide. This study aims to investigate the current practice of paediatric orthopaedic surgeons in diagnosing and treating DDH worldwide and identify points of agreement and disagreement...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28583152/utilization-of-ultrasonography-to-detect-developmental-dysplasia-of-the-hip-when-reality-turns-selective-screening-into-universal-use
#8
Rachel Wilf-Miron, Jacob Kuint, Ronit Peled, Asaf Cohen, Avi Porath
BACKGROUND: Developmental dysplasia of the hip (DDH) occurs in 3-5 of 1000 live births and is associated with known risk factors. In most countries, formal practice for early detection of DDH entails the combination of risk factor identification and physical examination of the hip, while the golden standard diagnostic instrument is hip ultrasonography (US). This practice is commonly referred to as selective screening. Infants with positive US findings are treated with a Pavlik harness, a dynamic abduction splint...
June 5, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28540520/the-pubo-femoral-distance-decreases-with-pavlik-harness-treatment-for-developmental-dysplasia-of-the-hip-in-newborns
#9
Daniel Augusto Maranho, Felipe Nunes Donati, Vitor Faeda Dalto, Marcello Henrique Nogueira-Barbosa
OBJECTIVE: To evaluate the evolution of the ultrasonographic pubo-femoral distance (PFD) before and after Pavlik harness treatment for developmental dysplasia of the hip (DDH) in newborns. PATIENTS AND METHODS: Twenty-five patients (16.7 ± 10.4 days; 19 females, six males) diagnosed with DDH and treated using the Pavlik harness were included. Eighteen patients had bilateral, and seven unilateral DDH, with a total of 43 dysplastic hips. The seven non-dysplastic hips in unilateral cases were used for comparison...
September 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28291024/pavlik-harness-treatment-for-pathological-developmental-dysplasia-of-the-hip-meeting-the-standard
#10
Qaisar Choudry, Robin W Paton
In the UK, the Pavlik harness is generally the accepted treatment technique for the treatment of neonatal and infant pathological developmental dysplasia of the hip. In 2013, the success rate of the Pavlik harness became an outcome measure from the British Society of Children's Orthopaedic Surgery for appraisal and revalidation with the GMC for paediatric orthopaedic surgery. The standard set requires an 80% success rate, with less than 20% requiring surgery. This study evaluated the outcomes of Pavlik harness treatment in neonates/infants with 'pathological hips' diagnosed by ultrasound imaging in a district general hospital setting...
July 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28271087/comparison-of-pediatric-and-general-orthopedic-surgeons-approaches-in-management-of-developmental-dysplasia-of-the-hip-and-flexible-flatfoot-the-road-to-clinical-consensus
#11
Ramin Haj Zargarbashi, Hirbod Nasiri Bonaki, Shayan Abdollah Zadegan, Taghi Baghdadi, Mohammad Hossein Nabian, Mehdi Ramezan Shirazi
Developmental dysplasia of the hip (DDH) and flatfoot are common pediatric orthopedic disorders, being referred to and managed by both general and pediatric orthopedic surgeons, through various modalities. Our study aimed to evaluate their consensus and perspective disagreements in terms of diagnostic and therapeutic approaches of the mentioned deformities. Forty participants in two groups of general orthopedic surgeons (GOS) (n=20) and pediatric orthopedic surgeons (POS) (n=20), were asked to answer an 8-item questionnaire on DDH and flexible flatfoot...
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28140383/pavlik-harness-disease-revisited-does-prolonged-treatment-of-a-dislocated-hip-in-a-harness-adversely-affect-the-%C3%AE-angle
#12
Alex L Gornitzky, Emily K Schaeffer, Charles T Price, Wudbhav N Sankar
BACKGROUND: Current dogma contends that prolonged treatment of a dislocated hip in Pavlik harness beyond 3 weeks will cause "Pavlik harness disease." To our knowledge, however, no previous studies have documented objective morphologic changes to the acetabulum from continued treatment of a persistently dislocated hip. METHODS: We retrospectively reviewed a consecutive series of infants with developmental dysplasia of the hip, below 6 months old, who failed Pavlik treatment from a single, tertiary-care pediatric hospital and a multicenter, international study group...
June 27, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28098581/timing-of-pavlik-harness-initiation-can-we-wait
#13
Jill E Larson, Anay R Patel, Brian Weatherford, Joseph A Janicki
BACKGROUND: Developmental dysplasia of the hip is effectively treated with a Pavlik harness (PH) within the first 6 months of life. Over 80% of unstable hips in the newborn period will naturally stabilize by 2 months of age. If there is no difference in the effectiveness of initiating PH treatment at 1 week compared with 4 weeks of age, waiting may allow the hips to naturally stabilize and avoid treatment. The purpose of this study is to evaluate whether the timing of PH implementation influences its effectiveness in the treatment of developmental dysplasia of the hip...
January 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28056254/-interpretation-of-american-academy-of-orthopaedic-surgeons-clinical-practice-guideline-on-the-treatment-of-pediatric-diaphyseal-femur-fractures
#14
W Chen, J Li, Y Z Zhang
The original guideline on the Treatment of Pediatric Diaphyseal Femur Fractures (PDFF) was developed by the American Academy of Orthopaedic Surgeons (AAOS) in 2009, and the guideline was updated by AAOS in 2015. In this reissue, all recommendations in the original guideline identified as"inconclusive" were removed with seven recommendations reserved and without new recommendations added. The recommendations in the current guideline were listed as follows: (1) Children younger than 36 months with PDFF should be evaluated for child abuse...
January 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27984689/-congenital-knee-dislocation-case-report
#15
C Arvinius, R Luque, C Díaz-Ceacero, F Marco
Congenital knee dislocation is an infrequent condition with unknown etiology. In some cases it occurs as an isolated condition, while in others it coexists with associated conditions or syndromes. The treatment of congenital knee dislocation is driven by the severity and flexibility of the deformity. The literature includes from serial casting or the Pavlik harness to quadriceps tendon plasty or femoral osteotomies. We report herein the case of a congenital dislocation treated with serial casting with a good outcome...
May 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27764890/developmental-dysplasia-of-the-hip-a-computational-biomechanical-model-of-the-path-of-least-energy-for-closed-reduction
#16
Mohammed A Zwawi, Faissal A Moslehy, Christopher Rose, Victor Huayamave, Alain J Kassab, Eduardo Divo, Brendan J Jones, Charles T Price
This study utilized a computational biomechanical model and applied the least energy path principle to investigate two pathways for closed reduction of high grade infantile hip dislocation. The principle of least energy when applied to moving the femoral head from an initial to a final position considers all possible paths that connect them and identifies the path of least resistance. Clinical reports of severe hip dysplasia have concluded that reduction of the femoral head into the acetabulum may occur by a direct pathway over the posterior rim of the acetabulum when using the Pavlik harness, or by an indirect pathway with reduction through the acetabular notch when using the modified Hoffman-Daimler method...
August 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27761220/targeted-screening-of-hip-dysplasia-in-newborns-experience-at-a-district-general-hospital-in-scotland
#17
Rahul Tyagi, Marcin R Zgoda, Rachel Short
National Health Service Quality Improvement Scotland (NHS QIS) published a health technology scoping report in 2006 acknowledging that there are serious concerns within Scotland in relation to Developmental Dysplasia of Hip (DDH) as there is no formal screening program in place and there are significant variations between NHS boards leading to confusion for staff and parents. NHS QIS identified need for audit work to improve hip screening in Scotland. The aim of this study is review of current practice of selective screening for DDH...
September 19, 2016: Orthopedic Reviews
https://www.readbyqxmd.com/read/27662383/graf-type-iv-hips-have-a-higher-risk-of-residual-acetabular-dysplasia-at-1-year-of-age-following-successful-pavlik-harness-treatment-for-developmental-hip-dysplasia
#18
Eduardo N Novais, Julia Sanders, Lauryn A Kestel, Patrick M Carry, Mariana L Meyers
BACKGROUND: We asked whether patient-specific factors and ultrasound (US) measurements of hip dysplasia severity at initial examination influence short-term residual acetabular dysplasia in patients successfully treated with Pavlik harness for developmental hip dysplasia. METHODS: After IRB approval, 134 hips (84 patients) successfully treated by the Pavlik method between August 2011 and October 2014 with follow-up at 12 months of age were identified. Early successful treatment was defined as normal examination and US after approximately 12 weeks of Pavlik treatment...
September 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27342120/education-of-parents-in-pavlik-harness-application-for-developmental-dysplasia-of-the-hip-using-a-validated-simulated-learning-module
#19
Kate E Gargan, Catharine S Bradley, Alexandra Maxwell, Joel Moktar, John H Wedge, M Lucas Murnaghan, Simon P Kelley
BACKGROUND: The Pavlik harness is the most common initial treatment for developmental dysplasia of the hip worldwide. During treatment, parents are required to re-apply the harness at home. Teaching parents how to apply the harness is therefore paramount to success. While simulated learning for medical training is commonplace, it has not yet been trialed in teaching parents how to apply a Pavlik harness. METHODS: A group of parents underwent a simulated learning module for Pavlik harness application...
August 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27194497/skill-acquisition-and-retention-following-simulation-based-training-in-pavlik-harness-application
#20
Joel Moktar, Catharine S Bradley, Alexandra Maxwell, John H Wedge, Simon P Kelley, M Lucas Murnaghan
BACKGROUND: Simulation-based learning is increasingly prevalent in many surgical training programs, as medical education moves toward competency-based curricula. In orthopaedic surgery, developmental dysplasia of the hip is a commonly treated condition, where the standard of care for patients less than six months of age is an orthotic device such as the Pavlik harness. However, despite widespread use of the Pavlik harness and the potential complications that may arise from inappropriate application, we know of no previously described formal training curriculum for Pavlik harness application...
May 18, 2016: Journal of Bone and Joint Surgery. American Volume
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