Child Orthopedics

Frequently Asked Questions

Our 3-month old son is supposed to wear a special harness to prevent hip dislocation. Both hips are affected, but one is worse than the other. And he's a regular Houdini. He can get out of that thing in just a few minutes. What can we do?

You have two other treatment options. There is an abuction brace that the infant or young child cannot get out of. It is more cumbersome and restrictive but it seems to do the trick.

Secondly, it may be time to consider reduction to correct the problem. If you can't keep the harness on and/or it's not working, then reduction is the next step. There are two ways to reduce or put the hip joint back in its socket.

Closed reduction is done with traction. A weight is attached to the leg and foot and applies a steady pull on the leg. The goal is to pull the leg down enough for the hip to relocate into the socket.

If this fails, then open reduction is indicated. The surgeon makes an incision large enough to be able to reach into the hip area and snip some of the soft tissues around the femur. The leg is pulled back down where it belongs. With either type of reduction procedure, the child wears a cast for six weeks to hold it in place until it heals.

Hakan Senaran, MD, et al. Avascular Necrosis Rate in Early Reduction After Failed Pavlik Harness Treatment of Developmental Dysplasia of the Hip. In Journal of Pediatric Orthopedics. March 2007. Vol. 27. No. 2. Pp. 192-197.

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