Obturator Dislocation During Pavlik Harness Treatment for Developmental Dysplasia of the Hip: A Rare Complication and Its Clinical Course.

Developmental dysplasia of the hip represents a spectrum of disorders ranging from mild acetabular dysplasia to complete hip dislocation. Early diagnosis and treatment are essential to prevent long-term complications. The Pavlik harness remains the first-line treatment for infants with reducible hip dysplasia or dislocation diagnosed within the first months of life and has demonstrated high success rates. However, complications related to its use may occasionally occur. One of the rare but significant complications is obturator (inferior) dislocation of the hip during treatment. We present the case of a two-month-old female infant diagnosed with Graf type IV developmental dysplasia of the right hip. Following reduction and treatment with a Pavlik harness, follow-up imaging revealed an obturator dislocation of the hip. The harness was discontinued, and closed reduction with subsequent casting was performed. Despite an initially successful reduction, the patient later developed persistent dysplasia, subluxation, and femoral head fragmentation. Long-term follow-up demonstrated improvement in hip stability, but residual acetabular dysplasia and deformity of the ossific nucleus were present, consistent with coxa plana. The patient is currently scheduled for a corrective pelvic osteotomy. This case highlights the importance of careful monitoring during Pavlik harness treatment and early recognition of atypical displacement patterns. Prompt diagnosis and appropriate management are essential to prevent further complications and optimize long-term hip development.