What is the major mode of treatment for a true neonatal hip dislocation?

• A. Closed surgical reduction
• B. Double or triple diapers
• C. Pavlik harness
• D. Spica cast

Answer: (C)

The primary approach for a true neonatal hip dislocation is to guide the femoral head into the acetabulum with a device that holds the hip flexed and abducted. The Pavlik harness achieves this by maintaining moderate flexion and abduction, allowing the joint to reduce gradually as the infant moves and grows. This noninvasive method is favored because it enables a safe, dynamic reduction and promotes proper acetabular development, while minimizing the risk of complications like avascular necrosis that can occur with more aggressive manipulations.

If reduction does not occur with the harness or if the hip anatomy is unfavorable, more invasive options are considered, such as closed reduction under anesthesia followed by a spica cast, or, in older infants or complex cases, surgical reduction. In contrast, older or less reliable methods like using diapers to abduct the hips do not provide the controlled positioning needed for reliable reduction and are not preferred.