What is Hip Dysplasia?

Hip Dysplasia is a comprehensive term that has been used to include a spectrum of related developmental hip problems in infants and children, often present at birth. Your doctor may have used one of the following diagnoses for your child instead:

• Congenital Hip Dislocation - where the hip is frankly dislocated, but reducible
• Congenital dislocatable hip - where the hip is in place, but dislocates fully when stressed
• Congenital subluxatable hip - where the hip is in place, but subluxatable, i.e., dislocates partially when stressed
• Acetabular dysplasia - where the socket is shallow and stays shallow, so that the hip is unstable

Incidence of hip dysplasia is 4 per 1000 live births. It occurs more frequently in girls, breech presentations, and first-borns. It also tends to run in families. It is believe that many of these cases may resolve spontaneously without treatment, but it is impossible to tell which will resolves. If left untreated, and the condition does not resolve on its own, the long-term consequences are very serious, including a shorter leg and a pronounces limp, with premature onset of arthritis and hip pain. For this reason, all physicians are very vigilant about checking for hip dysplasia at birth, and when detected, recommend treatment immediately.

How does the Wheaton-Pavlik™ Harness Help?

The hip is a ball-and-socket joint, and the aim of the treatment of hip dysplasia is to hold the hip in the reduced position to allow the head of the femur (the ball) to mold the acetabulum (the cup). This is usually the position of flexion and abduction. As the ball molds the cup, it deepens the cup, resulting in a stable hip.

The Wheaton-Pavlik™ Harness accomplishes this by holding the hips in a position of controlled hip flexion and abduction. Unlike a cast, the harness does not rigidly immobilize the hips, but allows movement, although in a controlled manner.

How do I care for the Wheaton-Pavlik™ Harness?

Your doctor has applied the Wheaton-Pavlik™ Harness and made the necessary adjustments to the shoulder and leg straps, to hold the hips in the optimal position for proper hip development. The front leg straps on either side control the amount of flexion, and the back leg straps on either side control the amount of abduction. You should not make any adjustments to the harness without first checking with your physician. markings should be placed on all four leg straps and both shoulder straps so that you can replace the harness in the right position if necessary.

For the first week or longer, depending on the stability of your child's hips, your physician may want the harness on at all times to maintain hip position. The harness is designed so that you can change the baby's diaper without having to undo the harness. To avoid soiling, use leak-proof diapers.

After the hip has stabilized, your physician may allow your baby to be out of the harness for a short period each day. Before removing the harness, note the location of the markings on each strap, and trace over any markings that may be fading. You may then bathe your child, and wash the harness if necessary.

Washing of the harness should be done by hand with a gentle detergent, and then allowed to drip dry. For faster, you may want to put it in the dryer by itself and under "AIR FLUFF - NO HEAT."

Clothing is not a problem in warm weather. Initially, when the harness has to be on the baby at all times, it has to be directly applied on the child's body. However, once the child is allowed to be out of the harness for a period each day, a daily change of undershirt and long knee socks is recommended to avoid skin irritation. In cold weather, blanket sleepers or gowns are recommended for outerwear.

Positioning of the baby on the back is preferable. For nursing purposes, mothers need to find a comfortable position for themselves and the baby could be propped sidewards if necessary with the help of pillows, provided the hips are kept abducted.

Your physician will be checking the baby regularly, and at each visit he will make the necessary adjustments to the straps. new markings should be applied to the straps after each adjustment.

Most infants need to be in the harness for about three months if the condition is discovered at birth. however, the duration of treatment, and the number of hours per day that your child needs to be in the harness will be determined by your physician.