{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:40:46Z","timestamp":1791423646692,"version":"4.3.3"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,3,20]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The Pavlik harness has been used for approximately a century to treat developmental dysplasia of the hip (DDH). Femoral nerve palsy is a documented complication of Pavlik harness use, with an incidence ranging from 2.5% to 11.2%. Rare reports of brachial plexus palsy have also been documented. The primary purpose of the current study was to evaluate the incidence of various nerve palsies in patients undergoing Pavlik harness treatment for DDH. Secondary aims were to identify patient demographic or hip characteristics associated with nerve palsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a retrospective review of patients diagnosed with DDH and treated with a Pavlik harness from February 1, 2016, to April 1, 2023, at a single tertiary care orthopaedic hospital. Hip laterality, use of a subsequent rigid abduction orthosis, birth order, breech positioning, weight, and family history were collected. The median (and interquartile range [IQR]) or mean (and standard deviation [SD]) were reported for all continuous variables. Independent 2-sample t tests and Mann-Whitney U tests were conducted to identify associations between the variables collected at the initiation of Pavlik harness treatment and the occurrence of nerve palsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Three hundred and fifty-one patients (547 hips) were included. Twenty-two cases of femoral nerve palsy (4% of all treated hips), 1 case of inferior gluteal nerve palsy (0.18%), and 2 cases of brachial plexus palsy (0.37%) were diagnosed. Patients with nerve palsy had more severe DDH as measured by the Graf classification (p &lt; 0.001) and more severe DDH as measured on physical examination via the Barlow and Ortolani maneuvers (p = 0.003).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Nerve palsies were associated with more severe DDH at the initiation of Pavlik harness use. Upper and lower-extremity neurological status should be scrutinized at initiation and throughout treatment to assess for nerve palsies. The potential for femoral, gluteal, and brachial plexus palsies should be included in the discussion of risks at the beginning of treatment. Families may be reassured that nerve palsies associated with Pavlik harness can be expected to resolve with a short break from treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.23.00948","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T15:03:41Z","timestamp":1710515021000},"page":"525-530","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Incidence of Nerve Palsies During Pavlik Harness Treatment for Developmental Dysplasia of the Hip"],"prefix":"10.2106","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1980-3201","authenticated-orcid":false,"given":"Preston W.","family":"Gross","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1159-1064","authenticated-orcid":false,"given":"Danielle E.","family":"Chipman","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8537-8200","authenticated-orcid":false,"given":"Kiranpreet","family":"Nagra","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3563-6696","authenticated-orcid":false,"given":"Olivia C.","family":"Tracey","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3097-0747","authenticated-orcid":false,"given":"Ruth H.","family":"Jones","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3746-1567","authenticated-orcid":false,"given":"John S.","family":"Blanco","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8221-8350","authenticated-orcid":false,"given":"Ernest L.","family":"Sink","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2715-7919","authenticated-orcid":false,"given":"David M.","family":"Scher","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-4341","authenticated-orcid":false,"given":"Emily R.","family":"Dodwell","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2991-9267","authenticated-orcid":false,"given":"Shevaun M.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"issue":"5","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/BPO.0b013e3181aa586b","article-title":"Familial predisposition to developmental dysplasia of the hip","volume":"29","author":"Stevenson","year":"2009","journal-title":"J Pediatr Orthop."},{"issue":"5","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/1471-0528.12013","article-title":"Risk of developmental dysplasia of the hip in breech presentation: the effect of successful external cephalic version","volume":"120","author":"Lambeek","year":"2013","journal-title":"BJOG."},{"issue":"4","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"153","DOI":"10.3390\/medicina56040153","article-title":"Developmental Dysplasia of the Hip: A Review of Etiopathogenesis, Risk Factors, and Genetic Aspects","volume":"56","author":"Harsanyi","year":"2020","journal-title":"Medicina (Kaunas)."},{"issue":"3","key":"bib4-20250430","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1097\/01241398-200305000-00012","article-title":"Pavlik: the man and his method","volume":"23","author":"Mubarak","year":"2003","journal-title":"J Pediatr Orthop."},{"issue":"3","key":"bib5-20250430","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1302\/1863-2548.12.180034","article-title":"Diagnostic and treatment preferences for developmental dysplasia of the hip: a survey of EPOS and POSNA members","volume":"12","author":"Alves","year":"2018","journal-title":"J Child Orthop."},{"issue":"2","key":"bib6-20250430","doi-asserted-by":"crossref","first-page":"238","DOI":"10.2106\/00004623-199072020-00011","article-title":"Use of the Pavlik harness in congenital dislocation of the hip. An analysis of failures of treatment","volume":"72","author":"Viere","year":"1990","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib7-20250430","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.otsr.2014.03.017","article-title":"Developmental dysplasia of the hip in neonates: evolution of acetabular dysplasia after hip stabilization by brief Pavlik harness treatment","volume":"100","author":"Bin","year":"2014","journal-title":"Orthop Traumatol Surg Res."},{"issue":"5","key":"bib8-20250430","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1007\/s11999-015-4388-5","article-title":"Success of Pavlik Harness Treatment Decreases in Patients \u2265 4 Months and in Ultrasonographically Dislocated Hips in Developmental Dysplasia of the Hip","volume":"474","author":"\u00d6mero\u011flu","year":"2016","journal-title":"Clin Orthop Relat Res."},{"issue":"281","key":"bib9-20250430","first-page":"29","article-title":"Use of the Pavlik harness for hip displacements. When to abandon treatment","author":"Harris","year":"1992","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"bib10-20250430","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/01241398-198202010-00002","article-title":"The Pavlik harness: results in patients over three months of age","volume":"2","author":"Kalamchi","year":"1982","journal-title":"J Pediatr Orthop."},{"issue":"7","key":"bib11-20250430","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.2106\/00004623-197658070-00017","article-title":"Congenital dislocation of the hip. Use of the Pavlik harness in the child during the first six months of life","volume":"58","author":"Ramsey","year":"1976","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib12-20250430","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/BF00266329","article-title":"Complications of the treatment of congenital dislocation of the hip by the Pavlik harness","volume":"3","author":"Suzuki","year":"1979","journal-title":"Int Orthop."},{"issue":"5","key":"bib13-20250430","doi-asserted-by":"crossref","first-page":"493","DOI":"10.2106\/JBJS.J.01210","article-title":"Femoral nerve palsy in Pavlik harness treatment for developmental dysplasia of the hip","volume":"93","author":"Murnaghan","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib14-20250430","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1177\/18632521231172986","article-title":"Femoral nerve palsy during Pavlik harness treatment for developmental dysplasia of the hip is not an indication for harness abandonment","volume":"17","author":"Ghanem","year":"2023","journal-title":"J Child Orthop."},{"issue":"1","key":"bib15-20250430","doi-asserted-by":"crossref","first-page":"e0579","DOI":"10.2106\/JBJS.CC.19.00579","article-title":"Brachial Plexus Palsy Because of Pavlik Harness Use: A Case Report","volume":"10","author":"Rizzi","year":"2020","journal-title":"JBJS Case Connect."},{"issue":"5","key":"bib16-20250430","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1097\/01241398-199409000-00024","article-title":"Brachial plexus palsy as a complication of Pavlik harness use","volume":"14","author":"Mooney","year":"1994","journal-title":"J Pediatr Orthop."},{"issue":"9","key":"bib17-20250430","first-page":"804","article-title":"EARLY DIAGNOSIS AND TREATMENT OF CONGENITAL DISLOCATION OF THE HIP","volume":"56","author":"Barlow","year":"1963","journal-title":"Proc R Soc Med."},{"issue":"119","key":"bib18-20250430","first-page":"6","article-title":"Congenital hip dysplasia in the light of early and very early diagnosis","author":"Ortolani","year":"1976","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib19-20250430","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1007\/BF00436138","article-title":"Classification of hip joint dysplasia by means of sonography","volume":"102","author":"Graf","year":"1984","journal-title":"Arch Orthop Trauma Surg (1978)."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.23.00948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:52:01Z","timestamp":1787752321000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.23.00948"}},"subtitle":["A Retrospective Cohort Study"],"short-title":[],"issued":{"date-parts":[[2024,1,25]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.23.00948","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,25]]}}}