Authors of section

Authors

Arnold Besselaar, Daniel Green, Andrew Howard

Executive Editor

James Hunter

General Editor

Fergal Monsell

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Pavlik harness

1. General considerations

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.

Applied Pavlik harness

2. Size of the harness

Measure the diameter of the infant’s chest at the nipple line and select a harness of appropriate size.

Determining the harness size

3. Application

Open the chest and shoulder straps and lie the opened harness on the table.

Preparation of harness for application

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.

Placement of infant on top of harness

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.

Adjusting the foot stirrups

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.

Fully adjusted and applied harness

4. Aftercare

The harness can be left on full time for approximately two weeks until the fracture is comfortable with early callus.