Pavlik harness pathology

In four patients (seven hips) with developmental dysplasia of the hip (DDH) treated with Pavlik harness for a prolonged period and followed by frequent clinical and radiographic examinations (sonography was not available at the time), persistent posterior dislocation was diagnosed. All hips required open reduction. Computed tomography (CT) scans and three-dimensional reconstructions demonstrated a consistent deficiency in the posterolateral acetabulum. Operative findings confirmed these pathologic changes. Constant pressure of the femoral head held by the Pavlik harness against the posterior acetabulum apparently causes this pathology.