Evaluation of Pavlik Harness Treatment Outcomes in Graf Type 2b Developmental Dysplasia of the Hip in Infants Aged 3–6 Months: A Retrospective Observational Study

Aim: To evaluate clinical outcomes of Graf type 2b developmental dysplasia of the hip (DDH) in infants aged 3–6 months, with particular focus on the association between Pavlik harness use and the need for surgical intervention.Materials and Methods: This retrospective observational study included 113 infants aged 3–6 months diagnosed with Graf type 2b hips based on ultrasonographic alpha angle measurements between 2019 and 2024. Demographic characteristics, perinatal factors, Pavlik harness use and duration were recorded. The primary outcome was the need for surgical intervention during follow-up (yes/no). Secondary analyses included descriptive evaluation of harness use and exploration of factors associated with surgery and/or harness use.Results: Among 113 infants (69.1% female), 83 (73.4%) received Pavlik harness treatment and 30 (26.6%) did not. Most treated infants used the harness for 3–4 weeks (66.2%). Overall, 9 infants (7.9%) required surgical intervention, while 104 (92.0%) avoided surgery. Surgery was required in 3 of 83 infants (3.6%) who received Pavlik harness treatment and in 6 of 30 infants (20.0%) who did not (p = 0.014). Breech presentation (94.7%) and swaddling (50.4%) were common in this cohort. No significant sex-based differences were observed in perinatal characteristics.Conclusion: In this single-center retrospective cohort of infants aged 3–6 months with type 2b DDH, Pavlik harness use was associated with a lower observed rate of surgical intervention. However, this association should be interpreted cautiously because treatment allocation was not randomized and potential selection bias cannot be excluded. Further multicenter prospective studies are warranted.