Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
HCPCS code
Name of the Procedure:
Hip Orthosis, Abduction Control of Hip Joints, Flexible, (Pavlik Harness), Prefabricated Item that has been Trimmed, Bent, Molded, Assembled, or Otherwise Customized to Fit a Specific Patient by an Individual with Expertise (HCPCS Code: L1620)
Summary
A Pavlik harness is a prefabricated device used to hold a baby's hips in a specific position to ensure proper hip joint development. It is customized to fit the infant's body by a qualified healthcare professional to treat certain hip conditions.
Purpose
The Pavlik harness is primarily used to treat Developmental Dysplasia of the Hip (DDH) in infants. The harness works by holding the baby's hips in an optimal position to promote proper hip development and reduce the risk of dislocation.
Indications
- Infants diagnosed with Developmental Dysplasia of the Hip (DDH)
- Newborns and infants who show signs of hip instability or dislocation
- Babies born with a family history of hip dysplasia
Preparation
- Diagnostic imaging like an ultrasound or X-ray may be conducted to confirm DDH.
- No specific preparation such as fasting or medication adjustment is usually required.
Procedure Description
- A healthcare professional with expertise in pediatric orthopedics will assess the infant's hip condition.
- A prefabricated Pavlik harness will be customized by trimming, bending, molding, or assembling parts to ensure a precise fit.
- The harness is fitted onto the infant to hold the hips in a 'human position of flexion and abduction.'
- The harness straps are adjusted to maintain the correct position of the hips.
- Regular follow-up appointments are scheduled to monitor progress and make necessary adjustments.
Duration
The fitting procedure takes about 30-60 minutes. The duration of wearing the harness varies but generally ranges from 6 to 12 weeks.
Setting
The procedure is usually performed in an outpatient clinic or a specialized orthopedic clinic.
Personnel
- Pediatric orthopedic specialist
- Trained orthopedic technician or nurse
Risks and Complications
- Skin irritation or breakdown due to pressure points
- Improper fit leading to ineffective treatment
- Unnoticed hip dislocation if not regularly monitored
- Rare: AVN (Avascular Necrosis) of the femoral head if used improperly
Benefits
- Promotes proper hip development in infants with DDH
- Prevents hip dislocation
- Reduces the need for surgical intervention if used early and correctly
Recovery
- Parents will be instructed on how to care for the harness and keep the infant comfortable.
- Regular follow-up appointments are necessary to adjust the harness and monitor hip development.
- Most infants adapt well and can move relatively freely while wearing the harness.
Alternatives
- Closed reduction and casting if the harness is ineffective
- Open surgical procedures in severe cases
- Watchful waiting in mild or borderline cases, though this carries the risk of worsening the condition
Patient Experience
- Babies might initially be uncomfortable but generally adapt quickly.
- Parents may need to adjust how they hold, diaper, and dress their baby.
- Pain is minimal; any discomfort is usually due to skin irritation rather than the harness itself.