Which Hip Abduction Device for Hip Dysplasia – and When?
Which Hip Abduction Device for Hip Dysplasia – and When?
Hip dysplasia (also known as DDH: Developmental Dysplasia of the Hip) is a condition in which the hip socket is not fully developed. Early treatment is crucial to prevent later problems and premature osteoarthritis.
In the Netherlands, national guidelines recommend different hip abduction devices depending on the child’s age, the severity of the dysplasia, and the success of earlier treatments.
Below we explain which device is used in which situation.
1. Pavlik Harness
Age: 0–6 months
Most commonly used in: almost all pediatric orthopedic centers in the Netherlands
Sources: Richtlijnendatabase, UMCG, LUMC
The Pavlik harness is usually the first step in treating hip dysplasia in young babies. It keeps the baby’s legs bent and spread apart, helping the hip joint to stay properly positioned in the socket so the socket can develop normally.
Advantages: soft, flexible, and allows for easy daily care.
Use: typically worn 23 hours per day, for several weeks to months.
Goal: to keep the hip head centered in the socket, allowing proper growth and development.
2. Camp Spreader (Abduction Brace)
Age: from around 6–7 months
Sources: Ziekenhuis Rivierenland, Radboudumc, LUMC, Slingeland Hospital
The Camp spreader brace is often introduced when the child is too big or heavy for the Pavlik harness.
Advantages: sturdy, easy to put on and take off for daily care, and suitable for older babies.
Use: often worn fewer hours per day than the Pavlik harness, depending on severity and ultrasound monitoring.
Goal: maintain the hip in an abducted position to further encourage proper socket development.
3. Hip Spica Cast
Age: variable, usually > 6 months
Sources: UMCG, Ziekenhuis Rivierenland, LUMC
A hip spica cast is used if both the Pavlik harness and the Camp spreader fail to produce sufficient results, or in cases of (sub)luxation. It is often applied after a closed or open reduction of the hip under anesthesia.
Advantages: very stable fixation, minimizing the risk of the hip dislocating again.
Use: worn for several weeks to months, sometimes with cast changes in between.
Goal: ensure complete stability after reduction so the hip can develop properly.
Summary Table
| Age | First Choice | Alternative / Next Step |
|---|---|---|
| 0–6 months | Pavlik harness | — |
| 6–12 months | Camp spreader brace | Hip spica cast if insufficient progress |
| > 6 months + dislocation or failed brace treatment | — | Hip spica cast after reduction |
📌 Parent tip: The choice of device always depends on the individual child’s situation and ultrasound results. Follow your pediatric orthopedic specialist’s advice closely to ensure the best possible outcome.
