Pavlik Harness

Topic Overview

A Pavlik harness is a splint that is often used to treat developmental dysplasia of the hip (DDH) in babies younger than 6 months. The harness has fabric straps and fasteners that fit around a baby's chest, shoulders, and legs. The harness holds the baby's legs in a spread position, with the hips bent so that the thighs are out to the sides. This keeps the head of the thighbone (femur) in the correct position in the hip socket for normal development. The harness also allows the baby to move the hip joint, which helps the thighbone to deepen the hip socket.

The Pavlik harness successfully makes the hip normal about 90% of the time.^{footnote 1} The harness is usually worn all the time for the first few weeks of treatment. The child may be able to be out of the harness for an hour or so each day for bathing and for the harness to be cleaned. Later, the child may need to wear the harness only at night or during naps. If the femoral head stays properly located in the hip socket and the hip joint is stable, the child is slowly "weaned" from the harness. The child may need to wear the harness for several months.

Because babies grow rapidly, the straps and fasteners may need to be adjusted every 1 to 2 weeks. If the harness is improperly positioned, bone or nerve damage can develop. The straps can irritate the baby's skin.

The harness fails to correct DDH about 10% of the time. In these cases, the harness is removed if the hips show no improvement after 3 to 4 weeks and other treatment options are explored.^{footnote 1}