Hello Pediatric List Serv Specialists!
I saw a patient who is 2 months old, but born at 35 weeks. She is 1 ft 10 in tall and 7 lbs. Her thighs have very little fat and are about the diameter/circumference of a quarter (seriously).
The patient has severe hip dislocation. The Ortho team has tried a Pavlik since she was born, but the Pavlik harness isn’t reducing her hip as much as needed. They asked us to put her in a Rhino cruiser (plastic hip abduction orthosis). I modified the Rhino Cruiser XS with a TON of modifications to fit. Now, she is not tolerating it (crying inconsolably when it is on as she does NOT do this when the pavlik is on).
Our ortho team would really like to go for a brace rather than a spica cast, unless they have to do it.
Does the LISTSERV have any input or suggestions on how to make a hip abduction brace for an infant so small? Did you do something custom and if no did you do anything different than just a “smaller” Rhino Cruiser style brace? Are there “Pavlik” style harness that you think work better than? Any other input?
We are happy to do custom, but would like to do it right the first time, not repeat the same problem over and over.
We do a lot of hip abduction braces, but usually the Pavlik works until they are “big enough” for something else, so this is a first for me.