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Pavlik harness

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https://www.readbyqxmd.com/read/28583152/utilization-of-ultrasonography-to-detect-developmental-dysplasia-of-the-hip-when-reality-turns-selective-screening-into-universal-use
#1
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
#2
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...
May 24, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28291024/pavlik-harness-treatment-for-pathological-developmental-dysplasia-of-the-hip-meeting-the-standard
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
October 20, 2016: 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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27177477/risk-factors-for-avascular-necrosis-after-closed-reduction-for-developmental-dysplasia-of-the-hip
#14
Mathew D Schur, Christopher Lee, Alexandre Arkader, Anthony Catalano, Paul D Choi
PURPOSE: The purpose of this study was to identify and evaluate risk factors of avascular necrosis (AVN) after closed treatment for developmental dysplasia of the hip (DDH). METHODS: A retrospective review of children diagnosed with DDH at a tertiary-care children's hospital between 1986 and 2009 was performed. The presence of AVN was assessed according to Salter's classification system. RESULTS: Eighty-two affected hips in 70 children with an average age of 10 months at closed reduction (range 1-31 months) and 5 years (range 2-19 years) of follow-up met the inclusion criteria...
June 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27154531/corr-insights-%C3%A2-higher-pavlik-harness-treatment-failure-is-seen-in-graf-type-iv-ortolani-positive-hips-in-males
#15
COMMENT
Mihir M Thacker
No abstract text is available yet for this article.
August 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27150210/a-comparison-of-the-contact-force-distributions-on-the-acetabular-surface-due-to-orthopedic-treatments-for-developmental-hip-dysplasia
#16
Kalenia M Márquez-Flórez, Octavio Silva, Carlos A Narváez-Tovar, Diego A Garzón-Alvarado
We used a three-dimensional rigid body spring model (RBSM) to compare the contact force distributions on the acetabular surface of the infant hip joint that are produced by three orthopedic treatments for developmental dysplasia of the hip (DDH). We analyzed treatments using a Pavlik harness, a generic rigid splint, and a spica cast. The joint geometry was modeled from tomography images of a 1-year-old female. The articular cartilage was modeled as linear springs connecting the surfaces of the acetabulum and the femoral head, whereas the femur and the hip bone were considered as rigid bodies...
July 1, 2016: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/27064468/hip-click-in-the-neonate-should-i-be-concerned
#17
REVIEW
Philip McClure, David A Podeszwa
Developmental dysplasia of the hip (DDH) requires precise evaluation and rapid treatment/referral to specialists to optimize results. The incidence of DDH ranges between 4/1,000 and 133/1,000 newborns depending on patient risk factors (female gender, breech birth, and family history). Multiple associations have been identified including metatarsus adductus, oligohydramnios, and muscular torticollis. Classic physical examination results are well known by pediatricians, but can be difficult to elicit. Ultrasound screening is a useful test in defining early dysplasia and dislocation, but can generate misleading results if used inappropriately...
April 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27035836/mr-imaging-in-postreduction-assessment-of-developmental-dysplasia-of-the-hip-goals-and-obstacles
#18
REVIEW
Daniel G Rosenbaum, Sabah Servaes, Eric A Bogner, Diego Jaramillo, Douglas N Mintz
Developmental dysplasia of the hip is a spectrum disorder of hip development that ranges in severity from abnormal acetabular morphology to complete hip dislocation. While treatment with a Pavlik harness is highly effective in infants younger than 6 months, older infants and children and those with orthotic failure often warrant surgical reduction and placement of a spica cast, which limits subsequent imaging evaluation. Magnetic resonance (MR) imaging has been described in the evaluation of the adequacy of hip reduction for more than 2 decades, but the practice is still not widespread and is performed routinely at relatively few centers...
May 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/26975383/higher-pavlik-harness-treatment-failure-is-seen-in-graf-type-iv-ortolani-positive-hips-in-males
#19
COMPARATIVE STUDY
Eduardo N Novais, Lauryn A Kestel, Patrick M Carry, Mariana L Meyers
BACKGROUND: Patients with developmental dysplasia of the hip (DDH) whose hips are dislocated but reducible (Ortolani positive) are more likely to experience Pavlik harness treatment failure than are patients with dysplastic and reduced but dislocatable (Barlow positive) hips. However, data regarding factors associated with failure are limited and conflicting. QUESTIONS/PURPOSES: We asked: (1) What is the frequency of Pavlik harness treatment failure among Ortolani-positive hips, Barlow-positive hips, and dysplastic hips? (2) What are the factors predictive of failure of Pavlik harness treatment for Ortolani-positive hips? METHODS: In this retrospective study we identified 150 patients who underwent the Pavlik harness method for treatment of DDH between August 2011 and July 2015...
August 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26854048/results-of-a-universal-ultrasonographic-hip-screening-program-at-a-single-institution
#20
Olcay Güler, Ali Şeker, Serhat Mutlu, Mehmet Halis Çerçi, Baran Kömür, Mahir Mahiroğulları
OBJECTIVE: The aims of the present study were to determine the prevalence of developmental dysplasia of the hip (DDH) in newborns screened by hip ultrasonography (US), to review outcome of follow-up and treatment of infants with DDH, and to evaluate the relationship between US-based diagnosis and risk factors. METHODS: A total of 9564 hips of 4782 newborns (2398 females, 50.1%) were evaluated with US. Risk factors for DDH and accompanying deformities were also recorded...
2016: Acta Orthopaedica et Traumatologica Turcica
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