Pavlik Harness and Developmental Dysplasia

Developmental dysplasia of the hip (DDH) is abnormal development of the acetabulum and/or femoral head that results in an unstable hip. The femoral head may be loose within the socket, partially displaced, or completely dislocated. Because the infant’s hip is still developing, repeated abnormal positioning can prevent the acetabulum from deepening normally and can make later reduction more difficult. Early DDH may be painless and visually subtle. A newborn can feed, sleep, and move both legs without appearing distressed. The absence of crying does not exclude the condition. The treatment goal is to centre the femoral head gently within the acetabulum while the joint is still mouldable, allowing normal growth rather than forcing a stiff or injured hip into position. The Pavlik harness supports this goal by holding the hips flexed and gently abducted while allowing movement of the knees and lower legs. It is not a device for forcing an irreducible dislocation into place. Its safety depends on correct fitting, preservation of circulation and nerve function, and close ultrasound follow-up.