Determination of hip position in the Pavlik harness.

Fourteen children treated for developmental dysplasia of the hip with a Pavlik harness were evaluated at the time of harness application with clinical examination, hip ultrasonography, and anteroposterior radiography. Ten orthopedic surgeons with experience levels varying from residents to experienced pediatric orthopedic surgeons evaluated the studies to determine hip position in the harness. Clinical examination agreed with hip ultrasonography for hip position in 100% of hips. Interpretation of radiographs agreed with ultrasonography in only 49% of cases in which the hip was judged to be dislocated and in 82% of cases in which the hip was judged to be reduced. When imaging is used to aid in assessing hip position during treatment with a Pavlik harness, ultrasonography appears to be superior to anteroposterior radiography for assessing hip position.