ACETABULAR DEVELOPMENT FOLLOWING EARLY TREATMENT OF HIP-DYSPLASIA BY PAVLIK HARNESS

One hundred sixty-two neonates with sonographically diagnosed developm ental dysplasia of the hip (200 hips) according to the method of Graf were treated with a Pavlik harness until sonographic maturation was re ached. Eight patients (12 hips) treated with closed reduction and rete ntion in a bilateral hip spica cast were included. When the children s tarted to walk their acetabular indices were assessed and demonstrated low-grade dysplasia in 26% and high-grade dysplasia in 6% according t o the criteria of Tonnis and Brunken. We discuss the current sonograph ic criteria defining treatment-induced normalization and the adequacy of the length of treatment. We conclude that despite normal values at the end of treatment dysplasia may develop, which necessitates further radiological monitoring of all hips initially rated at risk on sonogr aphy. When to end monitoring, however, remains to be determined.