Hip dysplasia in newborns
Most dislocations and subluxations are formed after the baby was born. Extremely rare dislocation of the hip joint, which occurs even in utero. This dislocation is called "metrologicheskie". When it acetabulum, and adjacent part of the bone of the thigh, are in the developed state.
From these pathologies children suffer from ancient times. First symptoms of dysplasia was described by Hippocrates, who began to straighten the legs babies with the help of cargo.
Hearing this diagnosis from a pediatrician, it is not necessary to panic, because in most cases, this pathology is treated. Especially in the world hip dysplasia occurs quite often: out of 1,000 newborns are born with about 25 babies. Moreover, it affects mostly female babies.
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Forms of hip dysplasia in newborns
There are three forms of dysplasia, depending on their complexity:
- Redviva which is characterized in that the head of the thigh bone is not fixed in the acetabulum, and the ability to move freely. Bundles that need to hold are relaxed, due to which the instability appears. Due to the fact that the changes are minor, self-detect this pathology is almost impossible. The joint can even normallyto function, but there is a risk of transition to a subluxation;
- The next, more difficult stage of dysplasia is called subluxation. In this case, the femoral head is shifted somewhat upward and to the side. It can go out of the acetabulum and to take the place, at this moment hear a click;
- The most dangerous and requires serious treatment is the stage called "hip dislocation". The head will be separate from the joint capsule and to shift a little back and up. Acetabulum is underdeveloped. It is the accumulation of fat and connective tissue.
Causes of hip dysplasia in newbornsAs the causes of hip dysplasia are the following factors:
Genetic predisposition and certain genetic characteristics. Doctors was the fact that dysplasia often affects those children whose mothers were also born with a dislocated hip;
- Unfavorable ecological situation in the area where there is a pregnant woman. According to statistics, children are prone to this malformation is more frequently if the mother's body is having the exposure to ionizing radiation, the accumulation of exhaust and even exposure to secondhand smoke;
- Age of women giving birth. The later will be born baby, especially if this is your first child, the greater the risk that it will be detected dysplasia;
Some diseases of the mother, such as fibroids and the presence of adhesions. Impact can also hormonal changes in the body, in particular, increased levels of progesterone;
- Severe somatic diseases of the mother;
Toxicosis in the early and late stages of pregnancy;
- Bad habits;
- The use of certain medication;
- Poor nutrition of a pregnant woman that causes the lack of vitamins and minerals in the body of the child. We are talking about calcium, phosphorus, iron, iodine and vitamin E;
- Incorrect positioning of the fetus in the womb: pelvic or breech presentation;
- Some of the features of the fetus: underweightor a short length of the umbilical cord;
The imbalance of water-salt metabolism of the fetus in connection with the pathology of the kidneys;
- Suffocation by an umbilical cord of a newborn;
- The trauma experienced by the child during or after childbirth.
Swaddling with hip dysplasiaWe should also stop swaddling of children with hip dysplasia. At the moment, scientifically established the connection between tight swaddling of infants and the increased incidence of dysplasia.
For example, in African and Asian countries children practically do not suffer from this disease. Due to the fact that babies are carried on the back, allowing them freedom of movement, dysplasia develops in them extremely rare.
Given this fact, the Japanese abandoned the tight swaddling of children that were in this country of ancient tradition. The result was not long in coming – the incidence has decreased in 10 times.
Moreover, the important role of broad swaddling cannot be underestimated in the prevention and treatment of existing dysplasia. This method gives very good results, especially if the wide used swaddling since birth. It promotes the proper formation of the articular tissues, normalize blood circulation and reduce the risk of subluxation and dislocation in children with dysplasia. Wide swaddling allows the baby not to be limited in freedom of movement, but constrains the limbs to the baby gradually adapt to the conditions of the big world. It not only soothes the child but also improves his sleep.
For wide changing Mat can be used as an ordinary diaper, and specialized fixtures. The latter include cases for a wide changing Mat and pillow frejka.
The symptoms of hip dysplasia in newborns
To the symptoms to determine the presence of dysplasia in the newborn include:
- Tension of spinal muscles, reflected in increased tone;
- Shortening of the leg, from which there is a malformation, relatively healthy limb;
- The presence of excess folds of the buttock;
- The position of stop. One or even both legs to be unnaturally turned outward;
- Asymmetry of folds onhealthy and diseased foot;
- The inability to completely breed the limbs of a newborn in hand. For this they have to bend at the knees;
- The child may be unusual for a healthy baby pose. His back is curved outward in the lumbar and scapula and the legs raised. This body position resembles the letter "C";
- The baby's head is tilted to one side. The fingers on one of the hands constantly clenched;
- So-called symptom of "slipping". It is characterized by a click is heard when raising the legs in the crumbs;
- Secondary symptoms, which include atrophied muscles adjacent to the affected joint, and low, barely listening to the pulse in the femoral artery.
Do not look for a combination of several signs to refer the child on reception to the orthopedist. If there is at least one of these symptoms, you should worry about the health of the baby in advance.
Diagnosis of hip dysplasiaFor diagnosis and clarification of the stage of dysplasia by doctors can be used the following methods and research:
- X-rays, have limitations. Given the age characteristics of the child, the study should be carried out in the shortest possible time with the use of special protective lining;
- Ultrasound diagnostics that you can use repeatedly, for the purpose of diagnosis and for further control. Ultrasound can reliably show clinical manifestations of the disease, as well as give the ability to define tone of muscles of lower limbs;
- Using computed tomography can detect additional parameters, for example, to determine the degree of atrophy of the muscles of the affected limb;
- MRI is used in the case when there is a need to conduct the operation;
- General inspection to detect external signs. First, he is a pediatrician and then a pediatric orthopedist. In the presence of suspected dysplasia it turns out the history of the disease.
Treatment of hip dysplasia in newborns
The earlier pathology is diagnosed and treatment is started, the faster rebound joint child. The very treatment depends on the severity of the disease. If we are talking about previlige, doctors practiced massage buttocks, thighs and lower back of a newborn. Recommendations for a wideswaddling, which was mentioned above. Also the child is sent for physiotherapy, which consisted of electrophoresis of the femoral joints with calcium chloride or aminophylline. At home it is necessary to carry out physiotherapy, which consists of a set of exercises.
If a child has a subluxation, it is necessary to use more radical methods of treatment. First and foremost, they are carrying a baby special stirrups, and following the recommendations for swaddling.
If the newborn is observed in the dislocation, he illustrates the overlay of the tire. Wearing time will depend on the severity of the disease. Sometimes if there are certain indications, apply surgical intervention. It lies in the fact that the head of the thigh bone right in the joint capsule, the remaining elements of the joint are adjusted, the muscles and ligaments tightened and lengthened. Can be used as an open reduction of the joint and its formulation in place with the use of an endoscope.
Rehabilitation activities are to strengthen the hip muscles, enhance the regeneration processes, the improvement of blood supply.
The implications of dysplasia in the newbornIf there is no treatment, at an early age it can threaten the child in serious trouble. Children develop a limp while walking, it may be as barely noticeable and pronounced. Also the kid can not take the leg out to the side, or will do so with great difficulty. The baby would be bothered by constant pain in the knees and in the pelvic region with a possible misalignment of the bones. Depending on the severity of symptoms of dysplasia in children is observed muscle atrophy varying degrees of severity.
Gradually, with the growth of the child, the consequences of untreated dysplasia will be aggravated and expressed in the development of the so-called "duck gait" when the baby rolls over from one foot to the other, sticking out his pelvis back. Motor activity of the child will be limited, which would entail underdevelopment of not only other joints, but also affect the work of all organs and the General physical development. In the future, the leg muscles can absolutely to atrophy, the person will begin to pursue continued pain. In adult patients, there is hyperlordosis of the spine in the lumbar. Also affects all organs located in the pelvic region.
All this can be avoided if time to start treatment and adhere to prevention measures.
Preventive measures aimed at eliminating the risk of developmentdysplasia are as follows:
- The timely implementation of ultrasound diagnostics. If it is not done in the hospital, sure his passing at the age of 3 months;
- Mandatory routine inspection of a doctor-a podiatrist;
- Avoidance of any vertical load on the limbs, until, until it is recommended by doctor;
- Wide swaddling and wearing the sling;
- Regular physical warm-up of the child in accordance with age;
- Compliance with all recommendations of the doctor and taking vitamin complexes mother on the stage of gestation.
The forecast for recovery is usually favorable. If treatment was started before the age of three, then the healing occurs in 97% of cases.
In this case, those children who did not receive adequate treatment up to six months, the appointment of the rehabilitation program at this age recover only 30% of cases. Therefore it is necessary to understand that dysplasia is a disease is curable, but to delay his treatment is impossible.