An infant aged 6 months with a newly noted hip dislocation on exam: which treatment is most appropriate?

An infant aged 6 months with a newly noted hip dislocation on exam: which treatment is most appropriate?

• A. Spica cast
• B. Pavlik harness
• C. Open reduction
• D. Triple diapering

Answer: (B)

In infants with developmental dysplasia of the hip, the best initial treatment when a dislocation is noticed in the first months of life is a Pavlik harness. This dynamic brace holds the hips in flexion and abduction, guiding the femoral head back into the acetabulum while allowing movement. It is noninvasive and has the highest success rate for reducing the hip in babies this age, while helping to minimize the risk of avascular necrosis when used correctly and monitored closely with follow-up exams and imaging as needed. If reduction with the Pavlik harness fails or if the hip cannot be reduced by this method, the next steps involve more definitive interventions such as open reduction, possibly with additional procedures, and immobilization after reduction (often with a spica cast). Triple diapering is not an effective treatment for this condition.

In infants with developmental dysplasia of the hip, the best initial treatment when a dislocation is noticed in the first months of life is a Pavlik harness. This dynamic brace holds the hips in flexion and abduction, guiding the femoral head back into the acetabulum while allowing movement. It is noninvasive and has the highest success rate for reducing the hip in babies this age, while helping to minimize the risk of avascular necrosis when used correctly and monitored closely with follow-up exams and imaging as needed.

If reduction with the Pavlik harness fails or if the hip cannot be reduced by this method, the next steps involve more definitive interventions such as open reduction, possibly with additional procedures, and immobilization after reduction (often with a spica cast). Triple diapering is not an effective treatment for this condition.