Pavlik Harness

Developmental dysplasia of the hip (DDH) occurs when the femoral head is not properly seated within the acetabulum (hip socket), ranging from instability to subluxation to complete dislocation. Ligamentous laxity and abnormal positioning during infancy allow the head to move out of the socket or prevent the acetabulum from developing around it. The Pavlik harness keeps the infant’s hips flexed and abducted so the femoral head remains centred in the acetabulum. This sustained, gentle positioning allows the socket to mould around the femoral head as the hip develops. The harness is not intended to force a stiff or irreducible hip into position. For an infant younger than 6 months, a Pavlik harness is first-line treatment when ultrasound confirms a reducible or dislocatable hip, commonly described as Graf type II–III dysplasia. The treatment decision depends on whether the hip can be reduced and maintained in a safe position, not simply on the presence of an abnormal ultrasound result. An irreducible dislocation or severe dysplasia requires a different orthopaedic approach.