RN Nursing · Musculoskeletal Disorders in Children · Practice question
A 3-month-old infant has been diagnosed with developmental hip dysplasia (DDH). The nurse plans care and provides education to the parents. Considering the infant’s age and diagnosis, which treatment approach should the nurse prioritize?
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Applying a Pavlik harness to maintain hip abduction and stability.
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Encouraging strict swaddling of the infant to limit hip movement and promote joint stability.
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Initiating a hip spica cast immediately to immobilize the hip joint.
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Recommending surgical correction followed by immobilization in all infants diagnosed with DDH.
Answer & explanation
Correct: Applying a Pavlik harness to maintain hip abduction and stability.
For a 3-month-old infant diagnosed with developmental dysplasia of the hip (DDH), the Pavlik harness is the first-line and most appropriate treatment. The Pavlik harness is a dynamic orthotic device that holds the hips in flexion and abduction, positioning the femoral head correctly within the acetabulum to allow normal joint development. This position promotes remodeling of the acetabulum and is most effective when initiated early in infancy, ideally before 6 months of age. When used correctly and consistently, success rates are high and surgery can often be avoided. Strict swaddling of the infant with the legs in extension is actually harmful in DDH because it places the hips in adduction, which can worsen dysplasia; this practice is strongly discouraged. A hip spica cast is typically reserved for infants who fail Pavlik harness treatment or for older infants and children after closed or open reduction procedures. Surgical correction is not recommended as an initial treatment for all infants; it is considered only when conservative measures fail or when the infant presents at an older age with irreducible dislocation. Therefore, applying a Pavlik harness is the correct and evidence-based priority for managing DDH in a 3-month-old infant.
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