Fixed abduction brace

What is a fixed abduction brace?

The fixed abduction brace is used to keep your baby’s hips in a hip-healthy position (abducted and flexed). Abducted means to keep the hips open and away from each other. It consists of a strap around the waist and two straps around each of the thighs.

Why does my baby need a fixed abduction brace?

The fixed abduction brace is a brace that may be used as an alternative treatment option for developmental dysplasia of the hip (DDH) instead of a Pavlik harness. Many factors may lead to your baby having a fixed abduction brace including having tried the Pavlik harness and it not being successful, the age of your baby and the severity of DDH.

Application

The fixed abduction brace is applied by the orthotist at your appointment. Your baby will be required to wear the fixed abduction brace full time during the course of treatment, except when changing diapers or bathing. This is different from the Pavlik harness which must be kept on full time at the beginning of treatment.

What are the risks of fixed abduction brace treatment?

Femoral nerve palsy is a rare condition caused by a trapped nerve at the hip. A trapped nerve occurs when too much pressure is placed on the nerve by surrounding tissue. This sometimes occurs in babies who use a fixed abduction brace. If this happens, your baby will not kick their leg out straight even when their toes are tickled. It will look as if your baby's leg has fallen asleep.

If you notice that your baby has reduced movement of their leg, and stops kicking, this may indicate that your baby has a femoral nerve palsy. It is advised that you take off the brace and contact your health-care team as soon as possible.

Skin irritation can occur with the fixed abduction brace as it is designed to be worn directly next to the baby’s skin. If skin irritation occurs, please contact your health-care team for suggestions. Note that clothing worn over the top of the brace should be very loose and you should never change the position of the harness straps or your baby’s legs.

General fixed abduction brace tips

The fixed abduction brace helps to keep the legs in a frog position with the legs falling out to the sides. It is important to avoid anything that pushes the legs together, such as car seats that are too narrow or swaddling in a way that brings the legs together.

The fit of the brace will be checked periodically by your health-care team and will be adjusted if needed.

Clothing

Thin, soft clothing such as a onesie can be worn under the brace. Cotton clothing under the brace may help to reduce skin irritation. Onesies that have snaps at the legs are easiest for diaper changes.

Diaper

The diaper must be worn under the brace. You will learn how to change your baby’s diaper in the brace before you leave from your appointment.

Travelling

When travelling with a baby in a fixed abduction brace it is important that the baby is in a car seat that is wide enough for the legs to be supported but not pushed together. Prolonged travel on a weekly basis is not recommended. If a long car trip is required, it is important to take breaks to allow the legs to fall out to the sides maximally.

Play time/tummy time

Play time in the fixed abduction brace is encouraged, including floor activities and sitting activities. Supervised tummy time is also encouraged.