Pavlik harness failed

[worried dad]

Hi,
I was just wondering if anyone can give me any advice.
My daughter's 'clicky hip' was missed at birth and only picked up by our GP on her 8wk check. After a ridiculous mix up with lost scans and faxes (which could only happen with the NHS), she eventually had a Pavlik harness fitted at the age of 4 months. We were told it would probably be on for 12 weeks and were really happy when, after 7 weeks, everything looked good on the USS and it was taken off.
Today, 3 months later, she's had a check up and they say the problem is still there and they want to put her in a cast for 3 months! I can't really get a straight answer from the Dr as to how it could revert back after being told that the hip was secure and fully formed.
We're all really upset about it as she's doing great and is so happy since the harness was removed. She was distraught with it on and she's going to be again with this cast.
Has anyone else had this problem? Is the cast any more likely to work than the harness? And if it does, what are the chances of the problem returning later... as it has once before? We were told in the beginning that it was a very mild case but now they can't seem to fix it.
I'm tired of getting answers from a text book everytime I ask a Dr... so I'm hoping people with experience can give me some help instead.
Thanks!

[wysiwyg]

Hi Worried Dad,

I take it from reference to the NHS you are in the UK ? Most of us on here are in Australia (although I am from the UK and have only been here a couple of years) but there are lots of us with experience of clicky hips/hip dysplasia - here is the link to the latest post in the hip dysplaysia support group

Hip Dysplaysia Support Group Thread

My daughter went into a Denis Brown Brace at 7 weeks, and came out of it at about 5 months, we have only had one follow up check since it came off and all looked ok, but they have always said there is a chance she may need further treatment, if the bone doesn't develop as they would like. My understanding is that the brace had put the joint back in place and corrected the angle but then need to wait to see the bone as opposed to cartilidge develop correctly. Did they say the hip was no longer secure? Or were they concerned about the angles?

There are lots of people in the support thread with experience of all the different types of brace and also casts.

[worried dad]

Thanks for the replies... I'm desperately trying to get a second opinion before they stick her in this thing! It's not easy here in the UK as all the consultants are both NHS and Private and so you end up going to the same people who aren't likely to contradict themselves!
On all previous assessments she had an US but the latest decision was based on an X-ray, which apparently isn't as conclusive.... so we're eally hoping for further assessment before any decision about harnesses or surgery is made.

[wysiwyg]

How old is your daughter? I know we have x-rays now (from 6 months) because once past a certain age the ultrasound can no longer show the joint as well as they would like (something to do with depth of tissue to see through and bone versus cartlidge). So if your daughter is a similar age an ultrasound may no longer be possible.

[worried dad]

Hi,

She's just over 7 months.

I heard that after a certain age that X ray is prefered but I've since been told that because it can't be assessed from different angles in 'real time', just having one x-ray is usually inconclusive and a number need to be done in various positions to give a clear picture of what's happening.

I've also read that once a baby is a certain age just feeling a click while manipulating the hip can't be relied on either because it can be the ligaments, which isn't a problem... a bit like when your wrist, fingers or knee clicks sometimes.

I know I'm probably clutching at straws here but I'm really hoping she doesn't have to go through this again. She was so upset with the pavlik and has really come on since it came off...

The hospital have called today and we've got an appointment on Fri, they've promised us their top consultant and want to do some more tests, including an US to see what's going on... I know they'll probably want to go ahead with the cast but fingers crossed evrything will show up ok.

Thanks for your help and advice... keep it coming!

[wysiwyg]

Coincidentally my sister in the UK sent me a link to an article on the BBC website about hip dysplasia - I tried to send you a PM of the link but you don't accept PM's. Anyway in it, it talked about a charity called STEPS - not sure if you have heard of it but was encouraging people with hip issues to use their internet site for support.

If you search the BBC site for 'Too many' baby hip cases ignored' you will find the article

[worried dad]

thanks! i'll check it out

[crosswig]

Worried Dad,

How did you DD go at her review? A couple of days ago I posted over at the main thread about our experience with the pavlik harness and how our paed thought it might have failed. DD's hips are still good but it was a bit of a tough time for us.

Crosswig

[Ange1]

Hi my name is Angela. I have a daughter called Ella who will be 6 weeks old tomorrow. We have been told she has clicky hips and will be going into a pavlik harness next week. Any advice for us on problems we may encounter that we have not thought of? Or any words of encouragement to tell us it's not that bad!!! We know its the best thing for her in the long term but it is still a bit difficult to digest.

[wysiwyg]

Hi Angela - check out this hip dysplasia support group thread there are quite a few of us who have been through the same

Hip Dysplaysia Support Group Thread

My DD went into a Denis Browne brace at 7 weeks, she was a big baby so skipped the Pavlik, her left hip was severe her right moderate, she came out the brace full time at 6 months, and for the last month was only overnight. So when caught early the correction time can be quite quick - just focus one day at a time, it took my DD two days to adjust and after that it didn't bother her at all - DH and I sometimes perhaps but she was cool with it. I have to go and put her to bed but check out the above thread as is a great source of support and there are mums in there who have had babies in the Pavlik so may be able to provide more specific advice on that particular brace.

[crosswig]

Any advice for us on problems we may encounter that we have not thought of?

Ange1 not sure of what you have already thought of but check out the main thread as there is heaps of useful information there.

DD2 went into a pavlik harness when she just under three months old. I was glad that she went into then as she was still sleeping a lot - and it meant she was out of the brace just as she was starting to get active. We had a rocker that DD2 spent a lot of time in during the day. I found that Aldi nappies were good. Their tabs are longer than Huggies and much softer so they didn't cut DD2. We got some men's hankies for bathtime. After a couple of washes they get softer and you can get more water out of them - so the harness doesn't get wet - than face washers.

When the harness first went on DD2 it was rough on her skin. The physio wrapped some soft gauze around the shoulder harness so it was soft against the skin. When we went to a larger size the physio offered us one of her second hand harnesses. It didn't look like much but there were not any problems with the harness being rough on DD2's skin.

They first couple of days will be rough but hang in there.

Crosswig