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Congenital Dislocation of the Hip and Pavlik's harness

Posted by Karen Faulkner on
Congenital Dislocation of the Hip and Pavlik's harness
Congenital Dislocation of the Hip (CDH) is a really important issue.

It occurs in around 1:100 births. It is more common in breech and large for gestational age babies. There may also be a heredity component hence the name congenital.

http://www.bbc.co.uk/health/physical_health/conditions/congenitalhipdislocation.shtml

I used to work with a midwife in Manchester, Jan and in the days before screening of risk factors Jan had CDH and had been missed. She had years of pain and eventually a double hip replacement by 35 years old!

http://en.wikipedia.org/wiki/Hip_dysplasia_(human)

Nowadays we screen antenatally by asking for family history of CDH. All breech babies are routinely given an ultrasound and any babies found to have a 'click' of the hips at the newborn check, 6-8 week check are again screened by an ultrasound.

These babies may have a partial dislocation and need to wear a soft harness (Pavlik's harness) for 6 weeks or so.

Pavliks harness

I met Frankie, just before Christmas at Basger's Pharmacy in North Bondi and she'd had a clicky hip at birth. This had been picked up on the routine paediatrician examination usually done in the first 24 hours. This was followed up by ultrasound scan at 6 weeks and again at 3 months. She has a shallow left hip socket so a decision was made to fit her with a Pavlik's harness for 6 weeks.This will get reviewed again when she's 5 months old.

At least we screen nowadays and we take action. Babies like Miss Frankie are so much better off than my midwife colleague, Jan. Watching the effects of her CDH really brought home the importance of good screening.

Frankie Pavliks harness

A big thank you to her mummy, Sarah, for letting me tell Miss Frankie's story.

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