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dc.contributor.authorİmerci, Ahmet
dc.contributor.authorRogers, Kenneth J.
dc.contributor.authorBhattacharjee, Abhishek
dc.contributor.authorBowen, James Richard
dc.contributor.authorThacker, Mihir M.
dc.date.accessioned2021-06-24T11:17:58Z
dc.date.available2021-06-24T11:17:58Z
dc.date.issued2021en_US
dc.identifier.citationImerci, Ahmet MD*,†; Rogers, Kenneth J. PhD, ATC*; Bhattacharjee, Abhishek PhD‡; Bowen, James Richard MD*; Thacker, Mihir M. MD* Risk Factors for Failure of Pavlik Harness Treatment in Infants With Dislocated Hips That Are Evaluated by Dynamic Sonography, Journal of Pediatric Orthopaedics: July 2021 - Volume 41 - Issue 6 - p e386-e391 doi: 10.1097/BPO.0000000000001799en_US
dc.identifier.issn02716798
dc.identifier.urihttps://hdl.handle.net/20.500.12809/9345
dc.description.abstractBackground: Frankly dislocated hips occur in ~1% to 3% of infants with developmental dysplasia of the hip and are often difficult to treat. In the most severely dislocated hips, the femoral head is positioned outside the posterior/lateral rim of the acetabulum and is irreducible, that is, the femoral head will not reduce by positioning the leg. The purpose of this study was to determine risk factors, using univariate and multivariate analyses, for Pavlik harness failure in infants who initially presented with irreducible/dislocated hips (confirmed by dynamic sonography). Methods: Following institutional review board approval, 124 infants (170 hips) with frankly dislocated hips treated using a Pavlik harness between 2000 and 2018 were evaluated. Patients' demographic characteristics, clinical findings, dynamic sonographic findings (dislocated-fixed vs. dislocated-mobile), age at onset of Pavlik harness treatment, duration of harness usage, and follow-up treatments were recorded. Univariate analyses were used to determine risk factors for treatment failure. Results: In frankly dislocated hips (confirmed by dynamic sonography to be positioned outside the posterior/lateral rim of the acetabulum), Pavlik harness treatment was successful in 104 of 170 hips (61%) while it failed in 66 hips. Mean follow-up was 4.86±4.20 years. Univariate analysis determined the risk factors to be onset of treatment after the seventh week of age (P=0.049) and initial mobility (dislocated-fixed group) (P<0.001) by dynamic sonography. In addition, multivariate analysis (P=0.007) showed infants of multigravida mothers (non-firstborn) to be another risk factor for failure. Six percent of hips with no risk factors failed Pavlik harness treatment, those with 1 risk factor had 42% failure, 2 risk factors had 69% failure, and all 3 risk factors had 100% failure. Conclusions: In our patients with frankly dislocated irreducible hips, 39% of hip failed Pavlik harness treatment. Independent multivariate, logistic regression analysis, and multivariate analysis determining the risk factors for failure of Pavlik harness treatment were onset of treatment after the seventh week of age, infants of multigravida mothers, and initial hip mobility (fixed-dislocated hips) by dynamic sonography.en_US
dc.item-language.isoengen_US
dc.publisherLippincott Williams and Wilkinsen_US
dc.relation.isversionof10.1097/BPO.0000000000001799en_US
dc.item-rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectPavlik harnessen_US
dc.subjectFailureen_US
dc.subjectDislocationen_US
dc.subjectDevelopmental dysplasia of the hipen_US
dc.titleRisk Factors for Failure of Pavlik Harness Treatment in Infants With Dislocated Hips That Are Evaluated by Dynamic Sonographyen_US
dc.item-typearticleen_US
dc.contributor.departmentMÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümüen_US
dc.contributor.institutionauthorİmerci, Ahmet
dc.identifier.volume41en_US
dc.identifier.issue6en_US
dc.identifier.startpage386en_US
dc.identifier.endpage391en_US
dc.relation.journalJournal of Pediatric Orthopaedicsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US


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