Literature DB >> 19308522

Pseudoparalysis in the Pavlik Harness: beware of septic arthritis.

Andrew J Stevenson1, Sandeep B Shewalle, Nicholas M P Clarke.   

Abstract

PURPOSE: Pseudoparalysis of the leg occurring during use of the Pavlik Harness (PH) is a seldom-reported condition. Three cases of pseudoparalysis are reported here to illustrate the need for careful assessment of this condition.
METHODS: A series of patients using the PH and presenting with pseudoparalysis was compiled following a retrospective review of case notes.
RESULTS: In 3 cases, infants treated for developmental dysplasia of the hip using the PH were found to have developed a pseudoparalysis of the affected limb. All presented with similar signs, with the infant being systemically irritable and reluctant to move the limb. In 2 of the cases, this was related to the harness-its removal resulted in recovery of the affected limb. The third case was proven to be septic arthritis, unrelated to the harness, and treatment by means of arthrotomy, intravenous antibiotics and use of the PH for hip stabilisation was used successfully. In the first two cases, the pseudoparalysis was noticed at routine review clinic, and clinical assessment, ultrasound scan and blood tests were performed. The case of septic arthritis was similarly assessed, following referral by paediatric physicians.
CONCLUSION: Pseudoparalysis in the PH is a rare event and requires careful investigation.

Entities:  

Year:  2007        PMID: 19308522      PMCID: PMC2656741          DOI: 10.1007/s11832-007-0052-2

Source DB:  PubMed          Journal:  J Child Orthop        ISSN: 1863-2521            Impact factor:   1.548


  19 in total

1.  Pavlik harness pathology.

Authors:  D Atar; W B Lehman; A D Grant
Journal:  Isr J Med Sci       Date:  1991-06

2.  Splintage for congenital dislocation of the hip. Is it safe and reliable?

Authors:  J Bradley; M Wetherill; M K Benson
Journal:  J Bone Joint Surg Br       Date:  1987-03

3.  Brachial plexus palsy as a complication of Pavlik harness use.

Authors:  J F Mooney; J R Kasser
Journal:  J Pediatr Orthop       Date:  1994 Sep-Oct       Impact factor: 2.324

4.  Medial knee instability complicating the Pavlik-harness treatment of congenital hip subluxation. Case report.

Authors:  E P Schwentker; R J Zaleski; S R Skinner
Journal:  J Bone Joint Surg Am       Date:  1983-06       Impact factor: 5.284

5.  Early failure of Pavlik harness treatment for developmental hip dysplasia: clinical and ultrasound predictors.

Authors:  J A Lerman; J B Emans; M B Millis; J Share; D Zurakowski; J R Kasser
Journal:  J Pediatr Orthop       Date:  2001 May-Jun       Impact factor: 2.324

6.  Avascular necrosis after treatment of DDH: the protective influence of the ossific nucleus.

Authors:  L S Segal; D K Boal; L Borthwick; M W Clark; A R Localio; E P Schwentker
Journal:  J Pediatr Orthop       Date:  1999 Mar-Apr       Impact factor: 2.324

7.  Monitoring the treatment of developmental dysplasia of the hip with the Pavlik harness. The role of ultrasound.

Authors:  G R Taylor; N M Clarke
Journal:  J Bone Joint Surg Br       Date:  1997-09

8.  Developmental hip dysplasia potentiated by inappropriate use of the Pavlik harness.

Authors:  G T Jones; P L Schoenecker; L S Dias
Journal:  J Pediatr Orthop       Date:  1992 Nov-Dec       Impact factor: 2.324

9.  Pitfalls in the use of the Pavlik harness for treatment of congenital dysplasia, subluxation, and dislocation of the hip.

Authors:  S Mubarak; S Garfin; R Vance; B McKinnon; D Sutherland
Journal:  J Bone Joint Surg Am       Date:  1981-10       Impact factor: 5.284

10.  Avascular necrosis and the Pavlik harness. The incidence of avascular necrosis in three types of congenital dislocation of the hip as classified by ultrasound.

Authors:  S Suzuki; N Kashiwagi; Y Kasahara; Y Seto; T Futami
Journal:  J Bone Joint Surg Br       Date:  1996-07
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