PTCase ReportThe Journal of manual & manipulative therapy2024

Treatment of developmental hip dysplasia with manual therapy following Pavlik harness failure: a case report with long-term follow-up.

Valeria Giorgi, Giovanni Apostolo, Laura Bertelè

PMID 38706305

WHAT IT FOUND

In a child whose hip dysplasia persisted after a Pavlik harness, daily manual therapy was followed by less limping, normal walking, and later X-ray findings.

This describes a case, not proof the therapy works.

Key findings

01After daily 10-minute manual therapy, the child had less limping and better stair climbing at a follow-up 5 months after presentation.

02At 2 years and 10 months, she walked, jumped, and ran normally, with no pain and symmetrical legs.

03At 7 years and 7 months, she walked and ran without limping or pain, and X-ray showed femoral head epiphyses in the inferomedial quadrant.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

This is a single case report, so it describes what happened to one child, not a pattern that can be generalized. There was no control group or comparison, so it cannot establish that MBM caused the improvement. The family declined recommended traction, casting, and surgery, so the natural course and other choices may have affected outcomes. The child also received water-based free play and was not advised to swim as a sport, which may have influenced motor development. Treatment frequency changed because the child resisted physical contact, so the reported dose was not constant.

The easy way to misread this

Do not conclude that MBM caused the long-term hip improvement or should replace surgery for DDH. This was a single case with no control group, and the family had declined recommended surgical options.

Read it on PubMed →