Orthopaedics - Caring for a child in a pavlik harness

A pavlik harness is used to treat unstable hip joints caused by congenital dysplasia.

A pavlik harness usually remains in place for approximately six to 12 weeks (or for as long as the doctor recommends). The harness will hold your baby’s legs in a frog-like position. This is the best position to allow the pelvis sockets to deepen around the thigh bone and for the hip joint to stabilize.

Positioning

• The harness must remain on your child 24 hours a day — do not remove it for any reason.
• To lay your child on their side, support them with a rolled-up towel or blanket. You must supervise your child at all times while they are in this position in case they roll over.
• Regularly check your child’s lower leg to ensure the toes are pink and the leg looks comfortable without excess pressure.
• If breastfeeding your baby, check that there is not too much pressure on the lower leg, which can cause poor circulation to the foot. If the position of the harness is making breastfeeding difficult, try under-arm feeding, placing pillows under your baby’s body when feeding in the usual position or lying down to feed.

Caring for the splint

• Cleaning a von Rosen splint is easy — it should be cleaned as often as your child.
• Do not use creams or oils on the skin near the harness.

Sleeping

• Safe sleep guidelines apply to babies in pavlik harnesses. For more information, see: www.sidsandkids.org/safe-sleeping/
• If in doubt, it is important to speak to your treating doctor before going home.

Bathing and hygiene

• Keep the harness dry at all times (unless your surgeon tells you otherwise).
• This means normal showers are not an option.
  Use sponge bathing to keep your child as clean as possible.
• Your child will develop red areas on their shoulders, lower limbs and chest. This should not be a problem and will disappear as your baby’s skin adjusts to the position of the harness.
• If you want to weigh your baby, subtract the weight of the harness from the scale display for close to accurate weight of your child. The approximate weights of the harnesses are:
  – o x small: 100g
  – o small and medium: 125 g
  – o large: 150g

Nappies

• Check your child’s nappy regularly to avoid soiling the harness.

Contact us immediately if you notice

• the harness appears too tight
• a rash developing
• you are unable to dry the skin.

Contact us

Orthopaedic Outpatients Department
Level 1, Queensland Children’s Hospital
501 Stanley Street, South Brisbane
t: 07 3068 2579
t: 07 3068 1111 (general enquiries)
e: chq_1borthoOPD@health.qld.gov.au

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Resource No: FS083. Developed by Orthopaedics Unit. Updated: March 2o15. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.