The Pavlik harness is the primary non-operative treatment for developmental dysplasia of the hip (DDH) in infants under six months. It holds the hips in a flexed and abducted position, encouraging the femoral head to locate and stay within the developing hip socket.
The Pavlik harness is a soft fabric harness with shoulder straps and stirrups that hold the baby's hips in a flexed, abducted position. It is fitted by an experienced orthopaedic team. The posterior strap limits adduction (prevents the legs from coming together) and the anterior strap maintains flexion. The harness is worn full-time initially, with adjustments made at regular clinic visits. Ultrasound monitoring confirms the hip is reducing and developing normally.
The Pavlik harness is the first-line treatment for DDH diagnosed in infants under six months with dislocatable or dislocated hips detected on clinical examination or ultrasound screening.
For very mild dysplasia in newborns, observation with repeat ultrasound at six weeks may be appropriate, as many mild cases resolve spontaneously. If the Pavlik harness fails, closed reduction under anaesthesia or open reduction may be needed.
Hip ultrasound confirms the diagnosis and guides harness fitting. The harness is fitted by a specialist and parents are taught how to manage it.
Success rates of 85–95% for Pavlik harness treatment in infants under six months with reducible hips. The earlier treatment begins, the higher the success rate.
Redness under the straps. Managed with padding and skin care.
Some babies are initially unsettled.
Nappies must be placed inside the harness. Parents need instruction.
If the harness is too tight in flexion. The anterior strap must not force excessive flexion. Resolves if recognised and the harness is adjusted.
Forced abduction can damage the femoral head blood supply. Risk is minimised with proper technique — the harness should guide, not force.
The hip may not reduce or may re-dislocate. Approximately 5–15% failure rate. Further treatment (closed or open reduction) is then needed.
Very rare, caused by excessive flexion.
No anaesthesia required. The harness is fitted in clinic.
Full-time wear for six to twelve weeks initially, then part-time (night-time) for a further six to twelve weeks as the hip stabilises. Regular ultrasound monitoring. Once the hip is stable and developing normally, the harness is discontinued. Long-term X-ray follow-up is recommended until at least two to three years of age, and ideally until skeletal maturity.
Weekly clinic appointments initially for harness adjustment and ultrasound monitoring. Frequency reduces as the hip stabilises. Long-term X-ray follow-up.
The harness is removed briefly for bathing, but the hips must be kept in the flexed, abducted position. Your team will demonstrate safe bathing technique.
Typically six to twelve weeks full-time, then a further period of part-time (night-time) wear. Total treatment time is usually three to four months.
Yes. Babies treated successfully with the Pavlik harness develop normal hips and walk at the normal age. Early treatment gives the best outcomes.