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Chapter 34: Problem 463

A baby has been diagnosed with developmental dysplasia of the hips and a Pavlik harness is applied. The Pavlik harness is a type of splint that abducts and flexes the hips while still allowing leg movement. The harness can be removed and reapplied by the parents. Instructions to include for the family caring for an infant in this type of harness would include: A. increase fluid intake to promote urine output. B. keep the harness on the child at least 23 hours a day. C. take the harness off at night if the baby is uncomfortable. D. the baby will need a high protein diet to allow hip repair.

Short Answer

Expert verified
B. keep the harness on the child at least 23 hours a day.

Step by step solution

01

Understand the Purpose of the Pavlik Harness

The Pavlik harness is used to keep the hip joints in a stable position by abducting and flexing the hips, which is crucial for the proper treatment of developmental dysplasia of the hips. It allows leg movement but maintains the hips in the correct position.
02

Evaluate Each Instruction Option

Consider the implications and accuracy of each instruction option with respect to the goal of treatment: A. Increasing fluid intake is generally good for health but it is not related to the effectiveness of the Pavlik harness. B. Keeping the harness on for at least 23 hours a day helps maintain hip position and ensure the effectiveness of the treatment. C. Taking the harness off at night would disrupt the consistent position needed for treatment. D. While good nutrition is important, a high protein diet is not specifically required for hip repair.
03

Select the Correct Instruction

Based on the evaluation, the correct instruction is to keep the harness on the child at least 23 hours a day to ensure the hips remain in the correct position for successful treatment.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

developmental dysplasia of the hips
Developmental dysplasia of the hips (DDH) is a condition that occurs when the hip joint is not formed properly in babies and young children. This can lead to an unstable hip joint that can easily dislocate. Early diagnosis and treatment are crucial to prevent long-term issues.

Signs of DDH include uneven leg lengths, asymmetrical skin folds in the thigh, and limited hip movement. It is often diagnosed through a physical exam and confirmed with imaging tests like ultrasounds or X-rays.

Treatment aims to ensure the hip joint is stable and can develop normally as the child grows. Common treatment methods include using a Pavlik harness, which keeps the hips in the proper position, or in some cases, surgery.
infant orthopedic treatment
Infant orthopedic treatment for conditions like developmental dysplasia of the hips (DDH) involves non-invasive methods and, if necessary, surgical intervention. For most infants with DDH, the Pavlik harness is a first-line treatment.

The Pavlik harness works by holding the hips in a flexed and abducted position, aiding the correct alignment and development of the hip joint. Parents play a crucial role in this treatment by ensuring the harness is worn consistently.

In some severe cases, or if the Pavlik harness is not effective, alternatives may include a closed reduction where the hip is manually placed back into the joint, often followed by casting. Finally, in extreme cases, surgical options include procedures to realign or reconstruct the hip joint, ensuring stable positioning.
Pavlik harness guidelines
The Pavlik harness is a specialized device used to treat developmental dysplasia of the hips (DDH) in infants. Key guidelines must be followed to ensure successful treatment.

Parents should be instructed to:
  • Keep the harness on for at least 23 hours a day to maintain proper hip positioning.

  • Adjust and apply the harness correctly, ensuring no twists or misalignments.

  • Inspect the baby's skin regularly for any signs of irritation or sores from the harness straps.

  • Follow up with regular medical check-ups to monitor progress and adjust the harness as needed.

  • Continue normal activities like diaper changes and gentle bathing while ensuring the harness stays in place.

It's crucial to explain these points clearly to the parents, emphasizing the importance of consistency in wearing the harness for the best outcomes in treating DDH.

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