Finding the best treatment for some conditions requires working backwards. In this study, 64 babies were treated from birth with a Pavlik harness. The harness is used for hip instability, meaning the hip is dislocated or dislocates easily. All 64 babies were followed for six months.
Results of treatment were compared with ultrasound (US) measurements. The goal was to see if the US tests could predict the results of treatment. They also looked at which measurements were the most accurate and reliable. Finding ways to reliably measure hip instability is important for making treatment decisions.
Ultrasound pictures of the hip can be used to measure hip angles. US can also show how much of the femoral head (top of the thigh bone) is covered by the acetabulum hip socket. This is called femoral head coverage (FHC).
In many cases, hip instability gets better without treatment. But it would be better to know in advance which hips won’t get better. That way treatment can get started right away.
The results of this study show that using the FHC is a good way to predict outcomes. There is both inter- and intra-rater reliability. That means the same person gets the same measurements when repeated more than once. It also means two different people can come up with the same results when measuring separately.
Looking back after six months, FHC at six weeks was able to predict the final outcome. Poor coverage of the femoral head suggests the need for early splinting. It can also give surgeons an idea of which babies will not be treated successfully with splinting, requiring surgery later on.