Shevaun Doyle & nerve palsies during Pavlik treatment of hip dysplasia

On today’s episode, I’m joined by Dr. Shevaun Doyle, a pediatric orthopedic surgeon from the Hospital for Special Surgery in Manhattan, New York. Dr. Doyle has an extensive practice focusing on both operative and nonoperative treatments for infantile hip dysplasia. We dive into her recent paper on nerve palsy in children undergoing brace treatment for hip dysplasia. We discuss whether the term "palsy" is accurate, explore rare nerve issues that can arise, and unpack possible mechanisms behind these complications. While these nerve issues almost always resolve, they can complicate treatment of the underlying condition. In a twist, Dr. Doyle flipped the script and interviewed me about my approach to managing failed Pavlik harness treatments and cases presenting at an older age. We talk about defining success after a closed reduction, counseling families on the spectrum of pathology, and the challenges of treating complex cases. We also touch on another paper she co-authored, which examines health states as a measure used in value-based care. This conversation reinforces that nonoperative treatment remains the gold standard for managing hip dysplasia.