Introduction
The Dennis Brown Hip Abduction Orthosis is used to hold a child's hips in a good position. It is used to treat developmental dysplasia of the hips, or “clicky hips” in babies.
It is often fitted after the removal of a hip spica, which is a plaster cast that covers the legs from the ankle to the bellybutton. It can also be used in the before, or after the removal of a Pavlik harness, which is a similar brace that includes shoulder and chest straps.
About this device
The hip abduction orthosis has two cuffs that go around the thighs. The cuffs are attached to a bar which holds the hips and knees up and apart. This lets the thigh and hip bones make contact and strengthens the muscles and ligaments.
The hip abduction orthosis is made from metal that is plastic coated. It is lined with plastazote, which is a foam that feels like a pool noodle, and hook and loop tape or Velcro fasteners to keep it in place.
Care of the device
The hip abduction orthosis can be washed with warm soapy water and towel dried only. Do not use heat to dry it as this will cause damage.
If your child's doctor has said you can remove the brace, wash it at least once a day. Make sure the brace is completely dry before putting it back on your child.
If your child's doctor has said to not remove the brace, you can wipe the inside of the thigh cuffs with a washer and dry well with a towel.
Sweat can get trapped between the skin and the hip abduction orthosis, which can cause skin irritation. You can prevent this by cleaning the hip abduction orthosis regularly and placing stockinet or similar cotton singlet material between it and the skin.
When to seek help
Speak to your child’s treatment team if you need help with adjusting the hip abduction orthosis.
Your child’s doctor will tell you how often your child should wear the orthosis and when it can be removed.
Management
Taking care of the skin
If your child's doctor has said the hip abduction orthosis cannot be removed, you will need to sponge bath your child.
If your child can remove the orthosis for bathing, you will need to make sure they are completely dry before putting it back on. Pay special attention to skin folds around the thighs where moisture can get trapped.
Check your child's skin regularly for any redness or irritation that may appear from rubbing, trapped sweat or other fluid. Contact your child's treatment team as soon as possible if their skin becomes broken or irritated.
Do not use any skin creams, powders, or oils under the hip abduction orthosis. These products can make the skin too soft, and trap sweat, causing irritation or broken skin.
The thigh and stomach bands are made from a soft metal and can be expanded by hand as your child grows. Keep the straps firm so they do not rub on the skin.
Clothing
Your child should be able to wear nappies as usual while wearing the hip abduction orthosis.
They should wear loose fitting or stretchy clothing over the top. Some clothing brands make items like swaddles and sleep sacks that are hip brace friendly.