GAY XUONG DUI - Bong CT (10-03-2014)

Using PAVLIK HARNESS in treatment
of femoral fractures for newborns


Overview

Femoral Fractures are rare. Especially in Neonates
The thighbone (femur) is the largest and strongest bone in the

body.
It can break when a child experiences a sudden forceful impact.




Overview
Femoral fractures resulting from birth injuries are rare
Incidence 0.13 per 1,000 live births (0,13/1000)


Cause
Twin pregnancies
Breech presentations
Prematurity
The baby is especially large
Difficulties in the process of born


Previous treatments

Bryant skin traction

Splints powder
Cast spica


Defect
Injure skin
long hospital stay
Difficult to clean for baby
Difficult for the breastfed baby
Posture make baby uncomfortable


New treatment
Using PAVLIK HARNESS for babies from 0 to 6 months


Pavlik harness

To used to treatment of congenital hip dislocation
It is also used in treatment of femoral fractures for newborns
Physiotherapist apply this method
Treatment time is about 4 weeks



Forte
Don’t Injure skin
Don’t stay at hospital
Minimal cost

Easy to clean for baby
Easy for the breastfed baby
Baby feel comfortable


Evidence-based medicine
J Pediatr Orthop. 2013 Sep;33(6):614-7. doi: 10.1097/BPO.0b013e318292464a.
Rush JK1, Kelly DM, Sawyer JR, Beaty JH, Warner WC Jr
 Ten patients with 10 fractures met inclusion criteria
 The average age of the patients : 2.2 months
 The average duration of Pavlik harness treatment was 43 days
 The average age at final follow-up was 5.2 years


Result
Treatment with the Pavlik harness provides for excellent clinical
outcomes with a minimal complication rate


Evidence-based medicine
J Pediatr Orthop. 1995 Jul-Aug;15(4):461-6.
Stannard JP1, Christensen KP, Wilkins KE.
Fourteen patients with 16 femur fractures sustained between birth and 18
months of age were treated with a Pavlik harness

All of the fractures went on to stable union within 5 weeks
 The average time at final follow-up was 20.1 months


Result

All of the fractures healed in good alignment, with leg-length
discrepancies < 1 cm

There have been no adverse results or complications as a result of
treatment with the Pavlik harness to treat femur fractures





Conclusion
There are many treatment of femoral fractures in neonates.
However pavlik harness use in the treatment of positive results by :
reducing the hospital stay
Minimal cost
 help them comfortable
easy to care for baby
avoid the Injure skin caused by other methods


Reference
 Bs Nguyễn văn Tiếp,Nhân

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