Scholarlink

Introduction <p>The Pavlik harness is the standard first-line treatment for developmental dysplasia of the hip (DDH) in infants younger than six months. However, the optimal strategy for discontinuation after successful hip reduction remains debated. This study aimed to compare clinical and radiological outcomes between immediate discontinuation and gradual weaning using the Frejka pillow following successful Pavlik harness treatment.</p> Methods <p>We retrospectively analyzed data from 144 infants (166 hips) with DDH treated with the Pavlik harness between 2012 and 2023. Patients were categorized into two groups: Group A underwent immediate cessation, while Group B was gradually weaned using a Frejka pillow. Radiological follow-up included acetabular index (AI), lateral center-edge angle (LCEA), and assessment of AVN based on the Kalamchi-MacEwen classification, up to five years of age.</p> Results <p>The two groups were demographically similar. There were no statistically significant differences in recurrence rates (Group A: 9%, Group B: 5%; <i>p</i> = 0.53) or AVN incidence (Group A: 6.25%, Group B: 10%; <i>p</i> = 0.55). Group B showed a non-significant trend toward higher LCEA values at five years (<i>p</i> = 0.08), potentially indicating better acetabular development. However, the slightly increased AVN rate in this group raises concerns regarding prolonged abduction.</p> Conclusion <p>Both immediate discontinuation and gradual weaning protocols yield comparable outcomes in terms of recurrence and AVN. While gradual weaning may offer marginal benefit in acetabular development, the potential vascular risks warrant further investigation. Larger prospective studies are needed to establish standardized discontinuation guidelines in DDH management.</p> Level of evidence <p>III, retrospective comparative study.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Does gradual weaning improve outcomes after successful Pavlik harness treatment in developmental hip dysplasia? A retrospective comparative study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月18日

查看全文
  • Soner Kocak,
  • Sabri Kerem Diril,
  • Mustafa Caliskan,
  • Gurkan Caliskan,
  • Esref Terzi,
  • Ali Ozyalcin,
  • Sumeyra Dogan,
  • Mehmet Akif Sahin,
  • Adem Sahin,
  • Abdulhamit Misir,
  • Cemil Erturk

摘要

Introduction

The Pavlik harness is the standard first-line treatment for developmental dysplasia of the hip (DDH) in infants younger than six months. However, the optimal strategy for discontinuation after successful hip reduction remains debated. This study aimed to compare clinical and radiological outcomes between immediate discontinuation and gradual weaning using the Frejka pillow following successful Pavlik harness treatment.

Methods

We retrospectively analyzed data from 144 infants (166 hips) with DDH treated with the Pavlik harness between 2012 and 2023. Patients were categorized into two groups: Group A underwent immediate cessation, while Group B was gradually weaned using a Frejka pillow. Radiological follow-up included acetabular index (AI), lateral center-edge angle (LCEA), and assessment of AVN based on the Kalamchi-MacEwen classification, up to five years of age.

Results

The two groups were demographically similar. There were no statistically significant differences in recurrence rates (Group A: 9%, Group B: 5%; p = 0.53) or AVN incidence (Group A: 6.25%, Group B: 10%; p = 0.55). Group B showed a non-significant trend toward higher LCEA values at five years (p = 0.08), potentially indicating better acetabular development. However, the slightly increased AVN rate in this group raises concerns regarding prolonged abduction.

Conclusion

Both immediate discontinuation and gradual weaning protocols yield comparable outcomes in terms of recurrence and AVN. While gradual weaning may offer marginal benefit in acetabular development, the potential vascular risks warrant further investigation. Larger prospective studies are needed to establish standardized discontinuation guidelines in DDH management.

Level of evidence

III, retrospective comparative study.