Femur fractures in infants: a new therapeutic approach.

Fourteen patients with 16 femur fractures sustained between birth and 18 months of age were treated with a Pavlik harness rather than traditional casting methods. All of the fractures went on to stable union within 5 weeks. Eleven fractures have been followed-up for > 12 months, with a range of 12-30 months, and a mean of 20.1 months. All of the fractures healed in good alignment, with leg-length discrepancies < 1 cm. There have been no adverse results or complications as a result of treatment with the Pavlik harness to treat femur fractures, including fractures of the proximal and middle thirds of the femur; nonambulatory infants; < 4 months old at the start of treatment or small size in selected infants up to 6 months old; and shortening of < 2 cm. Advantages of the use of the Pavlik harness include ease of application without general anesthesia, minimal hospitalization, ease of reduction, ability to adjust the harness (and therefore the fracture alignment) if the reduction is lost, minimal cost, and ease of nursing, bonding with, and changing diapers on the infant.