Arnold Besselaar, Daniel Green, Andrew Howard
The Pavlik harness can be used for femoral fractures in infants up to 3 months of age.
The principle is to splint the limb for comfort. Periosteal healing and modeling are rapid and reliable at this age.
Reduction of the fracture is not necessary.
Measure the diameter of the infant’s chest at the nipple line and select a harness of appropriate size.
Open the chest and shoulder straps and lie the opened harness on the table.
Place the infant on top of the harness.
Close the chest strap at nipple level allowing a two-finger space below the strap.
Attach the shoulder straps to keep the chest strap in position.
Remove the foot stirrups and place each foot into a stirrup.
Reattach the anterior strap to the medial buckle of the foot stirrup and adjust the length to produce 90° hip flexion.
Reattach the posterior strap to the lateral buckle of the foot stirrup. Do not overtighten the strap. Allow for full abduction and for adduction to neutral.
Mark the strap lengths to allow easier reapplication of the harness.
The harness can be left on full time for approximately two weeks until the fracture is comfortable with early callus.