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Pavlik Harness for DDH

Developmental dysplasia (or dislocation) of the hip (DDH) is an abnormal development of the hip joint. The ball at the top of the thighbone is not stable within the hip socket and the ligaments of the hip joint may also be stretched and loose.  This used to be called Congenital Dislocation of the Hip (CDH).  See factsheet  DDH.

Treatment

Babies with DDH often need to wear a brace. The Pavlik Harness is one type of brace used to treat DDH.  It has straps that are fastened around the baby's legs and held up by shoulder and chest straps.  This holds the hips and knees up with the legs apart. This is the best position for the hip joint to be in. It allows contact between the thigh and hip bones and helps strengthen the muscles and ligaments of the hip while it is developing.

Pavlik Harness RCH KHI

When does your baby wear the harness

Your surgeon or paediatrician may advise that your baby wears the harness either:

  • 24 hours a day without removing it at all, OR
  • All the time except when bathing.

At home care

Putting the harness on

  • The chest strap should be firm but you should be able to fit two fingers underneath it.   This allows the chest to move properly during breathing.
  • The ankle and lower leg straps should be firm to hold the foot, but not too tight.

Getting used to the harness

  • It takes some babies a couple of days to get use to the harness.  Some babies may cry a little or seem unsettled for the first couple of nights.  This should settle down after a few days.

Hygiene and skin care

  • If your doctor has said that the harness must be on 24 hours a day, it can not be removed for bathing. Your baby will then need a sponge bath. The orthotist will show you how to do this. Please try to always keep the harness dry.
  • If you are allowed to remove the harness for bathing.  Then only undo the Velcro straps to remove it. Do not adjust or undo the metal buckles.
  • When bathing your baby pay particular attention to the creases behind the knees and hip creases.  Dry the skin well with a towel before re-applying the harness.
  • Monitor your baby's skin daily. Take care to clean your baby's skin and if you notice any skin irritation or redness, contact the orthotist.

Nappies and clothing

  • Your baby can wear normal nappies under the Pavlik Harness.  When changing the nappy do not hold your baby's feet together, this will move the hips from the correct position.
  • Loose fitting clothes that do not pull the knees together should be worn over the harness.

Feeding

  • You will be able to continue breastfeeding when using the Pavlik Harness.  You will need to find a position that is both comfortable for you and your baby.

Positioning of your baby

  • Your baby will be sleeping on its back with the harness on.  It is important to change your baby's position to avoid a 'flat spot' developing on their head. The skull bones are very soft and the pressure of being in one position for too long can affect the shape of their head. See factsheet Plagiocephaly.
  • During sleep time the position of the baby's head should be varied to make sure the baby does not favour a particular side (left or right).
  • Supervised tummy time will decrease the risk of developing a flat spot on the back of the head.
  • It will also promote body stability, limb co-ordination and head control in your baby. 
  • Tummy time should be encouraged and the Pavlik Harness will not stop this.

Cleaning the harness

  • The Pavlik Harness should be washed only if ABSOLUTELY necessary.
  • Remove the soiled section of the brace (remember how it is attached), wash in cold water with soap and gently clean with a nail brush.
  • Blot dry with a towel, a hair dryer on low heat can be used.
  • Do not tumble dry the harness (it may shrink).

Potential problems

  • Femoral nerve palsy is a very rare problem that can happen when using a Pavlik Harness. If you notice that your baby stops kicking, contact the Orthotist as soon as possible.

Follow-up

  • The Orthotist will arrange regular appointments to monitor the progress of your baby's growth and adjust the harness as required.  Please remember that you need to book in advance to see the Orthotist. 
    You need to see them after you have seen the doctor, on the same day.
  • Contact the Orthotist if you have any questions or concerns regarding your child's treatment with a Pavlik Harness.

Key points to remember

  • Monitor your baby's skin daily. Take care to clean your baby's skin and if you notice any skin irritation or redness, contact the orthotist.
  • Always try to keep your baby's legs apart, especially when bathing with the harness off or putting your baby to sleep. 
  • Babies may cry a little or seem unsettled for the first couple of nights after the harness is first fitted.  This should settle down within a couple of days.
  • The Pavlik Harness should be washed only if absolutely necessary and do not tumble dry.

For more information

Individual instructions

  • Your child's Orthotist is: ____________________________________________________     
    Tel: (03) 9345 5870

 

 

 

 

Factsheet developed by the Orthotists and Prosthetic Department, RCH.  First published Sept2006. Reviewed Jan2007.

 

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