Use of an abduction brace for developmental dysplasia of the hip after failure of Pavlik harness use.

The authors reviewed the records of 15 infants who were treated with an abduction brace after Pavlik harness use for developmental dysplasia of the hip (DDH) failed. Failure was defined as persistent dislocation or instability of the hip. Thirteen of these 15 patients had resolution of DDH with the use of an abduction brace. The median time spent in the brace before stabilization of examination findings was 24 days; the median time in the brace before normalization of ultrasound parameters was 46 days. There were no complications with regard to use of the abduction orthosis. At final follow-up of an average of 3 years and 7 months, no patient had undergone surgery and no patient had residual dysplasia or avascular necrosis of the hip. The two patients in whom both the Pavlik harness and abduction brace failed went on to successful closed reduction and spica cast application.