SavedAdd your journal

Journals / Acta Medica Alanya / 2026 / Cilt: 10 Sayı: 3

Evaluation of Pavlik Harness Treatment Outcomes in Graf Type 2b Developmental Dysplasia of the Hip in Infants Aged 3–6 Months: A Retrospective Observational Study

3–6 Aylık Bebeklerde Graf Tip 2b Gelişimsel Kalça Displazisinde Pavlik Ateli Tedavi Sonuçları: Retrospektif Gözlemsel Çalışma

Semih Canpolat(kahramankazam devlet hastanesi)0000-0002-2471-3211
Omer Esmez(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ELAZIĞ FETHİ SEKİN ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ)0000-0002-4475-3501
Sefa Key(FIRAT UNIVERSITY)0000-0003-3620-936X
Mehmet Cakır(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ELAZIĞ FETHİ SEKİN ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0009-0007-1660-7084
Pages
311–316
Publication Date
2026-10-20
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Overall, 9 infants (7.9%) required surgical intervention, while 104 (92.0%) avoided surgery.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: To evaluate clinical outcomes of Graf type 2b developmental dysplasia of the hip (DDH) in infants aged 3–6 months, with particular focus on the association between Pavlik harness use and the need for surgical intervention.
📊
Key Findings & Data:Materials and Methods: This retrospective observational study included 113 infants aged 3–6 months diagnosed with Graf type 2b hips based on ultrasonographic alpha angle measurements between 2019 and 2024.
💡
Conclusion & Impact:Overall, 9 infants (7.9%) required surgical intervention, while 104 (92.0%) avoided surgery.
🔬Design:Araştırma Makalesi
📍Scope:2019 Verileri
⚙️Variables:kalça gelişimsel displazisi · Pavlik askısı · Graf tip 2b

Abstract

Aim: To evaluate clinical outcomes of Graf type 2b developmental dysplasia of the hip (DDH) in infants aged 3–6 months, with particular focus on the association between Pavlik harness use and the need for surgical intervention. Materials and Methods: This retrospective observational study included 113 infants aged 3–6 months diagnosed with Graf type 2b hips based on ultrasonographic alpha angle measurements between 2019 and 2024. Demographic characteristics, perinatal factors, Pavlik harness use and duration were recorded. The primary outcome was the need for surgical intervention during follow-up (yes/no). Secondary analyses included descriptive evaluation of harness use and exploration of factors associated with surgery and/or harness use. Results: Among 113 infants (69.1% female), 83 (73.4%) received Pavlik harness treatment and 30 (26.6%) did not. Most treated infants used the harness for 3–4 weeks (66.2%). Overall, 9 infants (7.9%) required surgical intervention, while 104 (92.0%) avoided surgery. Surgery was required in 3 of 83 infants (3.6%) who received Pavlik harness treatment and in 6 of 30 infants (20.0%) who did not (p = 0.014). Breech presentation (94.7%) and swaddling (50.4%) were common in this cohort. No significant sex-based differences were observed in perinatal characteristics. Conclusion: In this single-center retrospective cohort of infants aged 3–6 months with type 2b DDH, Pavlik harness use was associated with a lower observed rate of surgical intervention. However, this association should be interpreted cautiously because treatment allocation was not randomized and potential selection bias cannot be excluded. Further multicenter prospective studies are warranted.

Özet

Amaç: Graf tip 2b gelişimsel kalça displazisi (GKD) tanılı 3–6 aylık bebeklerde klinik sonuçların değerlendirilmesi ve Pavlik ateli kullanımının cerrahi müdahale gereksinimi ile ilişkisini araştırmak. Gereç ve Yöntemler: 2019–2024 yılları arasında ultrasonografide alfa açısına göre Graf tip 2b kalça tanısı alan 3–6 aylık 113 bebek retrospektif olarak incelendi. Demografik özellikler, perinatal faktörler, Pavlik ateli kullanımı ve süresi kaydedildi. Birincil sonuç ölçütü takip süresince cerrahi müdahale gereksinimi (var/yok) olarak belirlendi. İkincil analizlerde atel kullanımının tanımlanması ve cerrahi gereksinimi ve/veya atel kullanımı ile ilişkili olası etmenler değerlendirildi. Bulgular: Toplam 113 bebeğin (%69,1’i kız) 83’üne (%73,4) Pavlik ateli uygulanırken, 30’una (%26,6) uygulanmadı. Genel olarak 9 bebekte (%7,9) cerrahi müdahale gerekirken, 104 bebekte (%92,0) cerrahi gereksinimi olmadı. Pavlik ateli uygulanan 83 bebeğin 3’ünde (%3,6), Pavlik ateli uygulanmayan 30 bebeğin ise 6’sında (%20,0) cerrahi müdahale gerekti (p=0,014). Bu kohortta makat geliş (%94,7) ve kundaklama (%50,4) oranları yüksekti. Perinatal özellikler açısından cinsiyetler arasında anlamlı fark saptanmadı. Sonuç: Tek merkezli bu retrospektif kohortta, tip 2b GKD tanılı 3–6 aylık bebeklerde Pavlik ateli kullanımı daha düşük gözlenen cerrahi müdahale oranı ile ilişkiliydi. Bununla birlikte, tedavi seçiminin randomize olmaması ve olası seçim yanlılığı nedeniyle bu ilişki dikkatli yorumlanmalıdır. Çok merkezli prospektif çalışmalara ihtiyaç vardır.

🔖

Cite This Article

Canpolat, S., Esmez, O., Key, S., Cakır, M. (2026). Evaluation of Pavlik Harness Treatment Outcomes in Graf Type 2b Developmental Dysplasia of the Hip in Infants Aged 3–6 Months: A Retrospective Observational Study. Acta Medica Alanya, Cilt: 10 Sayı: 3, 311–316. https://doi.org/10.30565/medalanya.1778267

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (22)

  1. Kotlarsky P, Haber R, Bialik V, Eidelman M. Developmental dysplasia of the hip: What has changed in the last 20 years? World J Orthop. 2015;6(11):886-901. doi: 10.5312/wjo.v6.i11.886.
  2. Guille JT, Pizzutillo PD, MacEwen GD. Developmental dysplasia of the hip from birth to six months. J Am Acad Orthop Surg. 2000;8(4):232-42. doi: 10.5435/00124635-200007000-00004.
  3. Ran L, Chen H, Pan Y, Lin Q, Canavese F, Chen S. Comparison between the Pavlik harness and the Tübingen hip flexion splint for the early treatment of developmental dysplasia of the hip. J Pediatr Orthop B. 2020;29(5):424-30. doi: 10.1097/BPB.0000000000000667.
  4. Gulati V, Eseonu K, Sayani J, Ismail N, Uzoigwe C, Choudhury MZ, et al. Developmental dysplasia of the hip in the newborn: A systematic review. World J Orthop. 2013;4(2):32-41. doi: 10.5312/wjo.v4.i2.32.
  5. Yegen M, Atalar H, Gunay C, Yavuz OY, Uras I, Kaptan AY. Reduction of the dislocated hips with the Tübingen hip flexion splint in infants. Int Orthop. 2019;43:2099-103. doi: 10.1007/s00264-018-4239-6.
  6. Kelley S, Feeney M, Maddock C, Murnaghan M, Bradley C. Expert-based consensus on the principles of Pavlik harness management of developmental dysplasia of the hip. JB JS Open Access. 2019;4(4):e0054. doi: 10.2106/JBJS.OA.18.00054.
  7. Pavone V, Testa G, Riccioli M, Evola FR, Avondo S, Sessa G. Treatment of developmental dysplasia of hip with Tubingen hip flexion splint. J Pediatr Orthop. 2015;35(5):485-9. doi: 10.1097/BPO.0000000000000313.
  8. Ömeroğlu H, Köse N, Akceylan A. Success of Pavlik harness treatment decreases in patients ≥4 months and in ultrasonographically dislocated hips in developmental dysplasia of the hip. Clin Orthop Relat Res. 2016;474(5):1146-52. doi: 10.1007/s11999-015-4388-5.
  9. Ramsey PL, Lasser S, MacEwen GD. Congenital dislocation of the hip. Use of the Pavlik harness in the child during the first six months of life. J Bone Joint Surg Am. 1976;58(7):1000-4. PMID: 977608.
  10. Ulziibat M, Munkhuu B, Bataa A-E, Schmid R, Baumann T, Essig S. Traditional Mongolian swaddling and developmental dysplasia of the hip: a randomized controlled trial. BMC Pediatr. 2021;21(1):450. doi: 10.1186/s12887-021-02910-x.
  11. Mahan ST, Kasser JR. Does swaddling influence developmental dysplasia of the hip? Pediatrics. 2008;121(1):177-8. doi: 10.1542/peds.2007-1618.
  12. Akrami SM, Montazeri V, Shomali SR, Heshmat R, Larijani B. Is there a significant trend in prevalence of consanguineous marriage in Tehran? A review of three generations. J Genet Couns. 2009;18(1):82-6. doi: 10.1007/s10897-008-9191-y.
  13. Guner SI, Guner S, Peker E, Ceylan MF, Guler A, Turktas U, et al. Are consanguineous marriage and swaddling the risk factors of developmental dysplasia of the hip? J Membr Biol. 2013;246(2):115-9. doi: 10.1007/s00232-012-9509-4.
  14. Zehir, S., Işıkan, UE, Sipahioğlu, S., Sipahioğlu, ST, & Koruk, İ. (2013). Dört Hafta- Altı Ay Arası Bebeklerde Gelişimsel Kalça Displazisi Taramasında Ultrasonografik Çalışma Sonuçları. Fırat Tıp Dergisi, 18 (2), 117-121. https://izlik.org/JA48DG32TT
  15. Homer, C. J., Baltz, R. D., Hickson, G. B., Miles, P. V., Newman, T. B., Shook, J. E.,. & Sunshine, P. (2000). Clinical practice guideline: early detection of developmental dysplasia of the hip. Pediatrics, 105(4 I), 896-905.doi: 10.1542/peds.105.4.896.
  16. Yorgancıgil H, Aslan A, Demirci D, Atay T. Effect of age and surgical procedure on clinical and radiological outcomes in children with developmental dysplasia of the hip: A comparative study. J Acad Res Med. 2016;6(3):177-182. doi:10.5152/jarem.2016.1024.
  17. Fox A, Paton R. The relationship between mode of delivery and developmental dysplasia of the hip in breech infants: a four-year prospective cohort study. J Bone Joint Surg Br. 2010;92(12):1695-9. doi: 10.1302/0301-620X.92B12.24960.
  18. Håberg Ø, Foss OA, Lian ØB, Holen KJ. Is foot deformity associated with developmental dysplasia of the hip? Bone Joint J. 2020;102-B(11):1582-1586. doi: 10.1302/0301-620X.102B11.BJJ-2020-0290.R3.
  19. Li Y, Wang Z, Miao M, Xu Y, Shi J. Residual acetabular dysplasia after Pavlik harness treatment for Graf type II hips. J Child Orthop. 2023;17(4):306-14. doi: 10.1177/18632521231182423.
  20. Larwood JPJ, Idowu O, Elliott KGB, Lindisfarne EA, Aarvold A. Follow-up after successful treatment for developmental dysplasia of the hip using a Pavlik harness: is two years enough? Bone Joint J. 2025;107-B(4):495-500. doi: 10.1302/0301-620X.107B4.BJJ-2023-1213.R2.
  21. Zehir, S., Işıkan, UE, Sipahioğlu, S., Sipahioğlu, ST, & Koruk, İ. (2013). Dört Hafta- Altı Ay Arası Bebeklerde Gelişimsel Kalça Displazisi Taramasında Ultrasonografik Çalışma Sonuçları. Fırat Tıp Dergisi, 18 (2), 117-121. https://izlik.org/JA48DG32TT
  22. Homer, C. J., Baltz, R. D., Hickson, G. B., Miles, P. V., Newman, T. B., Shook, J. E.,. & Sunshine, P. (2000). Clinical practice guideline: early detection of developmental dysplasia of the hip. Pediatrics, 105(4 I), 896-905.doi: 10.1542/peds.105.4.896.