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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Encouraging strict swaddling of the infant to limit hip movement and promote joint stability.
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Recommending surgical correction followed by immobilization in all infants diagnosed with DDH.
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✓
Applying a Pavlik harness to maintain hip abduction and stability.
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Initiating a hip spica cast immediately to immobilize the hip joint.
Answer & explanation
Correct: Applying a Pavlik harness to maintain hip abduction and stability.
For a 3-month-old infant diagnosed with developmental hip dysplasia (DDH), the Pavlik harness is the first-line and age-appropriate treatment. The harness maintains the hips in flexion and abduction, positioning the femoral head correctly within the acetabulum. This sustained positioning allows the acetabulum to develop normally around the femoral head, gradually correcting the dysplasia without surgery. In infants under approximately 6 months of age, the Pavlik harness is highly effective when applied correctly and worn consistently, achieving successful reduction in the majority of cases. Strict swaddling with the legs together is actually harmful in DDH because it adducts the hips and pushes the femoral head out of the socket — the opposite of what is needed. Recommending surgical correction for all infants is incorrect; surgery is reserved for older children or those in whom conservative methods have failed, typically after 18 to 24 months of age or when closed reduction under anesthesia is required. Applying a hip spica cast immediately is not the initial approach for a 3-month-old; casting may be used after failed harness treatment or closed reduction, but not as a first-line intervention at this age. The Pavlik harness is the safest, least invasive, and most effective treatment at 3 months.
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