The Pavlik harness was used in the treatment of complete congenital
dislocation of one or both hips in a series of infants, on either an
outpatient or an inpatient basis. The results in the two groups were
compared. For the children treated as outpatients the incidence of
avascular necrosis of the femoral head was 7.2 per cent and for the group
treated as inpatients the rate was 28 per cent. Application of the Pavlik
harness allowed reduction of the hip by shifting the femoral head first to
the posterior part of the acetabulum through flexion of the hip, followed
by movement of the femoral head anteriorly into the acetabulum through
abduction of the hip, which is possible because of stretching of the
adductor muscles by the weight of the lower extremity. When the reduction
is obtained by forced abduction there is a greater danger of avascular
necrosis of the femoral head.