Causes and signs of hip dysplasia in newbornsPerhaps all mothers and dads are eagerly awaiting the birth of their baby. With the birth of the child appears more trouble, but these efforts are very pleasant. Parents try to give the child a caress and attention, but do not forget about his health.
Hip dysplasia in newborns is a fairly common disease, implying a congenital hip dislocation. It is caused by incorrect development or underdevelopment of joints. The disease is quite dangerous, since it can significantly slow down the development of the musculoskeletal system of the child.
If you start and do not treat dysplasia in newborns or even untimely detect it, the consequences can be very deplorable. There may be a shortening of the limbs, a violation of the walking process and permanent severe pain in the joints. That is why it is important as soon as possible to diagnose the disease in infants.
Symptoms of dysplasia of pelvic joints
Especially pronounced contractures of dislocation doctors will notice already in the hospital. Restriction of normal mobility in the hip joint is a sign of dysplasia. But in some cases, hypoplasia of the hip joint is less pronounced, as a result of which the problem can be identified only 2-3 weeks after the birth of the child.
Symptom of abnormal development of the hip joints is the asymmetry of the folds on the toes of the baby
Young mothers can independently detect signs of dysplasia by doing gymnastics with the baby. The following signs will help to identify the presence of joint underdevelopment:
- at gymnastics, a limited hip extraction is detected( normally the angle of tap reaches 170 degrees);
- legs in elongated state have different lengths;
- asymmetry of inguinal or gluteus folds;
- characteristic click in the hip joints when the legs are spread apart;
- at a later stage - later getting up on the legs or breaking when walking.
If you find at least one of the symptoms of dysplasia, you need to show your child to the orthopedic doctor as soon as possible. Upon examination, he will confirm or refute the suspicions of the parents and, if necessary, immediately prescribe the necessary treatment.
Causes, forms and treatment of the disease
Doctors agree that the main cause of dysplasia lies in the genetic predisposition. If in a family someone had problems with the musculoskeletal system, the chance of having a baby with such a disease increases. Also, the cause may be infectious and endocrine diseases, which the woman suffered during the bearing of the child. In this case, the maturation of the locomotor system is impaired.
Hip dysplasia in the baby can develop due to inadequate fetal positioning of the fetus. This is a pelvic, gluteal or transverse presentation. This disease of the hip joints can be a consequence of severe toxicosis. Threats of miscarriage during pregnancy can also cause the development of this disease in infants.
There are several forms of the disease:
- incorrect development of the hips of the proximal part.
Rotational dysplasia of the hip joints is less common than other forms. This change in the configuration of the pelvic bones, which leads to a violation of the interaction of the hip and knee joints. There is rotational dysplasia in the form of clubfoot in a child.
The acetabular form of the disease is characterized by acetabular dysfunction. There are three types of such violations. The first is the pre-hip of the hip, the second - the subluxation, and the third - the dislocation. In the first case, there is a slight deviation in the development of the hip apparatus, the acetabulum is oblique. With subluxation of the femur, a partial displacement of the cervix and femoral head occurs. If a dislocation is diagnosed, then the femoral head is completely displaced upwards. If the proximal part develops improperly, the neck-diaphyseal angle can have a normal, enlarged or reduced shape.
To correct the legs use special stirrups
Treatment largely depends on the form of the disease. If the disease is detected in a timely manner, it can be cured within a month. Therapy usually consists of a wide swaddling of newborns or the imposition of tires, but only if the disease was detected immediately after birth. The orthopedist can also advise wearing the stirrups.
Hip dysplasia requires an integrated approach to treatment. Every day it will be necessary to visit the children's polyclinic, where the child will be given a massage and exercise therapy. Physiotherapy is also indicated.
Orthopedist can show mother infants gymnastic exercises that are easy to perform with the baby at home. Such charging will speed up the recovery of the baby.
Prophylaxis and treatment of hip dysplasia in newborns
Deviation in the development of hip joints is today called dysplasia. In earlier times, this pathology was defined as a hip dislocation. With this diagnosis, there may be a violation of various joint structures, including the femoral head, acetabulum and connective tissue. The manner in which the femur is located relative to the articular cavity determines the degree of severity of the pathology.
It is noteworthy that in newborn babies the hip joint is not yet fully developed structure. This is not in itself a danger and falls under the definition of the norm, because over time, as far as the load is distributed correctly, the formation of bone and connective tissues takes place. But there is a number of indirect signs that help to distinguish the pathology of from the normal development of the joint.
Probable causes of the development of the pathology of
To determine which factor caused the formation of dysplasia of the hip joint in each specific case is almost impossible. But there are a number of possible reasons, each of which could well serve as a starting point for the beginning of the deviation development: the
- breech presentation of the fetus , while the motor activity of the fetus decreases, the chances of an anomaly of the hip joint in this case increase if the child has a long timesuch a situation;
- anhydrase also helps to reduce the mobility of the baby;
- birth injury represents a danger to the child's body, as a result may be a dislocation of the limbs;
- hormonal reorganization of in a pregnant woman often occurs with visible disorders, which can lead to the possibility of developing various pathologies in newborns, including hip dysplasia;
- gynecological diseases of the mother , as a result of which the movements of the fetus are also hampered, for example, the adhesive process;
- tight swaddling does not allow the hip joints to form correctly, because the movements of the baby are again constrained;
- studied the relationship of environmental problems in certain areas with an increased percentage of dysplasia diagnosis;
- , the heredity of can not be excluded, since if the pathology of the hip joint is not found in the family for the first time, respectively, the risk of diagnosing this deviation will increase in the future;
- race , while in Scandinavian countries, there are twice as many cases of hip joint pathology.
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Risk groups, forms and stages of dysplasia
Taking into account the fact that the hip joint is not yet fully formed in the newborn and this is the norm, there is a possibility of erroneous pathology diagnosis, since the immature joint is in the borderline state, but there is still noviolations in its development. That is why it is important to get the results of a complete examination before making a diagnosis, as the clinical signs are not always obvious.The risk group includes cases where the joint is not completely formed, and much depends on how effective the preventive measures will be.
It is also noted that such a pathology in girls is detected much more often than in boys.
It is accepted to classify dysplasia of TBS in newborns according to stages of :
- . The preterm is characterized by the decentralization of the femoral head in the articular cavity, however, at this stage it is difficult to distinguish developing pathology from the immature joint by means of indirect signs.
- The second stage is called subluxation .The main symptom is the slip effect, when the head of the femur passes through the boundaries of the acetabulum, that is, literally "slips."This occurs during the ghost in the movement of the lower limbs. Reverse movement returns the hip head to its original position.
- dislocation is the most severe degree of this pathology and is characterized by an increase in general symptoms, as well as manifestation of visible disorders of posture, lameness.
There are also several basic forms of this pathology, since it can manifest itself in a different way, in addition to acetabular dysplasia. There is an rotational pathology of the hip joint and of the proximal femur dysplasia .In order to diagnose one of the forms of abnormality, a survey should be carried out, which will include measuring the cervico-diaphyseal angle of the joint and the geometry of the bones.
The main symptoms of
Both parents and doctors have the opportunity to observe various clinical symptoms of this deviation, however, statistics show thatcases are quite common when absolutely healthy children have signs that can characterize dysplasia.
This is why an external examination is not enough to make a diagnosis, and the symptoms are only an indirect manifestation of the deviation. There is a number of features of :
- limitation of lower limb leads, while bending the legs in the knees and trying to maximally dilute them;
- asymmetry of skin folds on the hips and buttocks, to control this feature, it is necessary to put the baby on the stomach and straighten the legs;
- the lower extremities have different lengths, that is, there is a visible shortening as a result of the development of pathology;The
- slip effect, which is characterized by the exit of the femur from the acetabulum, is determined by dilution of the lower limbs;
- audible click in the thigh area while moving the legs.
Diagnostic techniques for timely detection of the disease
The first action aimed at determining possible deviations in the development of the child's osseous system should be an examination by an orthopedic surgeon .In the maternity hospital, doctors determine the presence or absence of this pathology by means of clinical signs.But parents are advised to visit a specialist when the child is 1 month old, and then repeat the examination at 3 months.
If there are any disputable symptoms, the doctor will send you an additional examination: ultrasound or x-ray .It is important to know that ultrasound is ineffective in diagnosing dysplasia, since it is quite difficult to avoid large errors in measuring the geometry of bones. X-rays will give much more accurate results, however, in view of the physiological characteristics of the child's organism, it is recommended that it be performed no earlier than 4 months of the baby.
Parents should be aware that early diagnosis of this pathology allows the child to be cured in a short time and as painlessly as possible. The later the hip dysplasia in newborns is determined, the more severe the treatment methods and the longer the recovery period.
Methods for treatingdisease The absence of any action that contributes to the proper formation of the femoral joints or the straightening of the developing deflection will lead to a deterioration in the condition of the joint structures over time. Also aggravating the situation is the increase in body weight as the child grows, as this increases the load on the joints and there is an irreversible deformation, which is corrected only in the operative way.
If hip dysplasia is detected in a newborn, it is almost always enough to use for conservative treatment, , that is, you can do without an operation. orthopedic tools are the main place in the correction of the hip joint abnormalities, among them:
- Pavlik's aspiration - is used in cases when dysplasia is diagnosed, including hip joint dislocation in newborns( the most difficult stage), and underdevelopment of the hip joints. The device consists of a chest belt, which is held on the shoulders of the child, and directly "stirrups".These elements are interconnected by additional belts. Thus, Pavlik's stirrups allow the toddler to be in the frog's position. It is recommended to wear it from the age of three weeks.
- Becker's "Knickers" have a similar design, but the legs of the child to the knees are fixed. Used at the age of 1 to 9 months.
- Functional bus with spacers .This may be an option with popliteal or femoral tutors. The tire rigidly fixes the legs in a certain position. It is recommended for treatment at the age of 1 to 3 months.
- The Freewheel is structurally different from the previous versions and is a lock that is located between the legs of the child. The latch is held by the straps on the shoulders of the baby.
- The Ergo Backpack is used from 5 months and allows the child to take the correct pose.
- Sling also performs a corrective function. This device can be used from the first months of life crumbs, as this is an excellent preventive tool against hip dysplasia.
In addition to the use of orthopedic appliances, massage, exercise therapy or electrophoresis is recommended. Often, together with the application of tires or stirrups, all of the listed additional methods of treatment are prescribed.
Prognosis for cure and prevention
The vast majority of newborns diagnosed with "hip dysplasia" recover after a short but timely treatment.An important aspect here is the level of neglect of the child's condition. Happens, in especially difficult cases, the situation can be remedied only through surgical intervention.
As a preventive measure, it is recommended that regardless of the orthopedist's visit schedule, take a massage course, wear the baby on the hip, if he already holds his back, use the wide swaddling method.
Video: Preventive exercises and methods of massage for the initial stages of dysplasia
Anatomy of the pathology of
Even in absolutely healthy children, just emerging, the structure of TBS is not fully formed structure( immaturity), and this is relatedpossible problems.
For reference. The immaturity of the hip joint in the infant( type 2a) is a physiological component, a concept that includes delayed development of the joint due to various causes. Dysplasia - initially wrong formation of TBS.Both of these concepts were previously united into one, and the treatment was the same. However, it should be remembered that the line between the two diseases is very thin and if you do not start to observe the newborn with the diagnosis of "hip joint development( type 2a)" in time, you can get all the "delights" of dysplasia with all the ensuing consequences.
The system of ligaments in children has such differences from adult TBS:
- Newborns have a large vertical articulation in the joint.
- Newborn ligaments are more elastic.
- In the newborn, the acetabulum has a more flattened structure.
The femur does not move upwards due to the limbus( cartilaginous plate of the articular cavity).If there are congenital disorders in the development of the joint( underdevelopment), the hollow becomes flatter. Excessive elasticity prevents the bundles from holding the TBS head in one position. In case of violations in its development, the shape, size, and overall geometry of the bones may change.
If the time does not begin treatment and do not correct the congenital dysplasia( immaturity) in children, the limbus turns out with a shift up. Strongly deforming, it is no longer able to hold the head inside the acetabulum. The slightest careless movement of the baby can lead to subluxation and even dislocation.
Forms of the disease
The immaturity of TBS in newborns has several varieties:
- Acetabular( congenital abdominal pathology).
Immature dysplastic joint of newborns( type 2a according to the Earl) - a fairly common phenomenon. If the elasticity of the ligaments and changes in the centralization of the head in the acetabulum have slight deviations, the usual therapeutic massage plus charging quickly corrects this deviation. Practically all children in the first month of life can have this or that degree( more often they put type 2a) underdevelopment( immaturity) of the hip joint. Therefore, the examination of babies starts from the second month, when the tendency of cartilaginous strengthening of TBS is already visible. If serious anxiety occurs earlier, an unscheduled ultrasound is performed( according to Graf - an underdeveloped dysplastic joint of newborns - type 2a).
- Femoral dysplasia in the proximal part.
Congenital disorders of bone development in the proximal part( underdevelopment) are changes in the neck-diaphyseal angle. The indicator is calculated along the line connecting the centers of the neck and the head of the femur, and along the line of the diaphysis. Detecting the pathology in children can have a frontal X-ray.
- Rotational dysplasia( immaturity).
In girls, hypoplasia of the hip joints is 5 times more common than in boys.
This developmental disorder, which changes the angle between the TBS axis and the knee axis( in the horizontal plane).Geometric anatomical measurements in a healthy person have the following indicators: in infants - about 35 °, in children by three years - 25 °, in an adult - 15 °.With age, the angle decreases due to the vertical position of the body. With excessive antithesis( a change in the degree of angle), the centering of TBS in the acetabulum is impaired.
Congenital malformations of the joints in children may be a consequence of the course of the mother's pregnancy, so the following factors affect the occurrence of pathologies:
- Treatment with potent drugs during pregnancy. Acute leaking toxemia.
- Presence of chronic diseases in pregnant women.
- Family predisposition.
Hip dysplasia in newborns - treatment, prevention, diagnosis
Dysplasia is a pathology that denotes a congenital defect of the hip joint, expressed in increased mobility of the femoral head inside the joint. Dysplasia of hip joints in newborns is of two types( one-sided and two-sided).The group of hip dysplasia in young children also includes: congenital preluxation, congenital subluxation and congenital dislocation.
How does hip dysplasia occur in newborns?
Now hip dysplasia in newborns is very often diagnosed by orthopedists. Many will think a frightening diagnosis, but if you turn to a specialist in time and follow all the prescribed procedures, the diagnosis can be lifted. The most important early diagnosis and early treatment. In mild cases of dysplasia of the hip joints, the child is prescribed massage, LUTS and gymnastics, and for heavier cases, use struts that support the legs of the baby in the bent and dilated state. The duration of wearing in each case is determined individually. The first time the strut should be on the baby around the clock. It is forbidden to remove the tire yourself and let the baby rest from the struts. Also, when dysplasia of the hip joints are not allowed to put the baby on his feet without consulting a doctor.
The danger of dysplasia of the hip joint is the beginning of the treatment, which can lead to the development of complications such as full hip dislocation, lameness, scoliosis, or coxarthrosis of the hip joint, which is usually accompanied by severe pain, gait is disrupted,which ultimately leads to disability.
Diagnosis and treatment of hip dysplasia
Symptoms and symptoms of hip dysplasia in infants are not the symmetry of the folds of the hips and buttocks, the turn of the foot, the crying of the child when the hips are sideways, the length of one leg is clearly less than the other, and excessive looseness in the joints.
First of all, early diagnosis is necessary, which should be based on careful study of the history and conduct of medical examination. Pediatricians in the hospital should carefully examine the baby for the presence of dysplasia of the hip joints. Also, the pediatrician, who leads your child, at each reception should conduct a diagnostic test - to plant the baby's legs in the sides. From the side where there is a dislocation, a click will occur. If a specialist has a suspicion of congenital dysplasia of the hip joints, the child is referred for ultrasound diagnosis of the hip joints and for examination to the pediatric orthopedist. In the presence of dysplasia or suspicion of it, the orthopedist has the right to prescribe the x-ray of the hip joints. This will diagnose the deviation in the joint state.
Treatment begins immediately if the doctor determines the diagnosis of a hip dislocation. Parents should be patient, the treatment of hip dysplasia is long, continuous, and difficult to perceive the baby.
- Wide swaddling ( how to do it - tell the doctors).
- Therapeutic gymnastics. Bend the hips at each change of the diaper and changing the child.
- It is useful to swim on the stomach.
- Massage performed strictly by a specialist. Massage with dysplasia of the hip joint removes the increased tone of the lower extremities, improves blood circulation, which has a beneficial effect on the improvement of the nutrition of the cartilaginous tissue, ligaments and nerves. It is better to spend it once a day, when your baby slept, not hungry and is in a good mood.
- Spacers. Carefully follow all the doctor's recommendations to avoid complications and, in most cases, to one or two years the diagnosis can be withdrawn.
- When a child has grown up, it is recommended that the bike ride with the pedals on a wide pedal, exercise in warm water, swimming, systematic exercise.
Exercises for hip dysplasia
- It is necessary to stroke the outer surface of the toe from the lower leg to the thigh within two to three minutes;
- Rinse the baby foot with your fingertips for about a minute. Try to penetrate deeper into the tissues, while feeling the joint, but do it without pressure and applying strength;
- Flex the toe baby in the knees and hip joints, simulating cycling;
- Bend and unbend legs together and in turn. One leg was bent in the knee, the other was straightened and so on in turn.
If the conservative treatment is ineffective, the operable method is used. The essence of surgical treatment is the repositioning of the head of the femur and the restoration of the anatomic correspondence of the elements of the hip joint. The scope of the operation is determined individually for each patient. There are operations that openly dislocate dislocation, pelvic surgery and operations on the proximal femur.
There are several forms of dysplasia:
- I type - normally formed joint.
- II type - a slight disruption of the development of the hip joint.
1) Transient( up to three months) 2) Dysplasia of mild degree( after three months) 3) Anterior thighs
Hip dysplasia: symptoms of the cause and treatment in newborns
Hip dysplasia is an inferiority of the development of the hip joint of the bones,in case of disturbances in its structure, mainly due to an incorrect position of the femoral head in the acetabulum.
When a dysplasia occurs, the joint capsule is stretched, the underdevelopment of the ligamentous apparatus, and the acquisition of the acetabulum by a flat ellipsoid shape. The head of the femur, as a rule, remains normal, but in some cases may undergo pathological changes.
Disease leads to restriction of functions of the affected limb. In the absence of adequate therapy, signs of secondary coxarthrosis develop over time.
Statistics of Congenital Dysplasia
The incidence of the disease among newborns is about 2% of the total.In boys, dysplasia registers 4 times less frequently than than in girls.
In ecologically unfavorable regions, the incidence of infants reaches 12%.The risk of disrupting the development of the hip joint is higher among children who were born in breech presentation. Bilateral lesion of the joints is a rather rare phenomenon.
Causes of the disease
The hereditary factor in the appearance of dysplasia plays an important role. Before , 40% of the of all cases develop in children whose parents have had symptoms of congenital hip dislocation.
The causes of of the genetic structure and functioning disorder of the joint can be the following:
- the wrong position in the baby in childbirth;
- birth injury
- taking certain medications during pregnancy;
- severe toxicosis;
- drug-induced pregnancy retention in case of threat of miscarriage;
- infections carried during fetal gestation;
- of thyroid disease in the mother;
- deficiency of vitamins during fetal development;
- poor ecological situation;
- harmful working conditions of the mother;
- hormonal disorders in the body of a pregnant woman.
In some cases, hip dysplasia is combined with a variety of other fetal abnormalities( hydrocephalus, myelodysplasia, torticollis).Since the left limb of the fetus is usually pressed against the wall of the uterus, dysplasia of the left hip joint is more common.
What are the types?
There are three main types of disease:
Acetabular dysplasia. Is in the anomalies of the development of the acetabulum.
Epiphyseal dysplasia , or Meyer's dysplasia. Affects the proximal part of the thigh;there are pathological changes in the neck-diaphyseal angle, which causes the shape of the head of the femur. There are two subtypes of epiphyseal dysplasia:
- disease with an increase in the neck-diaphysial angle;
- disease with a decrease in the neck and diaphyseal angle.
Rotational dysplasia. represent various violations of the relative location of bones in the horizontal plane.
Separately, there is a condition in which there is a slowdown in the development of the joint. There are no obvious violations of the arrangement of bones in this case;this phenomenon is not considered dysplasia, but becomes borderline, with a combination of factors that can flow into the disease.
Degrees of development of
Currently, distinguishes three degrees of dysplasia , differing in the severity of ongoing processes:
- The first degree of ( pre-acute, "mild dysplasia").There is some deviation in the development of the hip joint;the femoral head is located in the oblique acetabulum.
- Second degree of ( subluxation).There is a partial displacement of the head and neck of the femur upward and outward relative to the articular cavity.
- Third degree ( dislocation).The femoral head is completely displaced from the acetabulum upwards.
Insufficiency and incorrect selection of therapeutic measures can lead to the transition of mild disease to severe, accompanied by hip dislocation.
Symptoms and signs
Clinical signs of dysplasia in a child may include:
- Skin fold asymmetry. It is revealed when examining the hips in front and behind with their preliminary extension in the upper part, with the feet being brought to each other. The normal number of folds on the thigh is 3;in any case, the location of the folds should be the same. With dysplasia, this amount increases on one hip, both when viewed from the front surface and gluteal.
- Restriction of limb leads ( during the Barlow test).Normally the child's legs can be diluted 90 degrees;The presence of dysplasia allows you to do it no more than 60 degrees. This symptom is characteristic only for subluxation and dislocation of the hip joint.
- Click symptom ( slipping of Marx-Ortholani).The check is carried out in the supine position on the back. It is necessary to wrap the knee joints so that the thumbs of the hands are located under the child's knee, and the rest on the outer surface of the leg. When pressure is exerted along the hip axis and the limb is withdrawn and brought up, a slight click is heard. This symptom is found only in the first weeks of a child's life, then disappearing.
- Shortening of the damaged limb , determined by the height of the knee joints. Such a sign, as a rule, appears after one-year-old age of the child, in newborns it is observed only in severe stages of dysplasia.
Additional symptoms of hip dysplasia may be:
- soft cranial bones;
- valgus or varus staging of the foot;Torticollis
- violation of sucking and search reflexes.
Consequences of dysplasia for a child
Children with dysplasia, in comparison with their peers, later start walking. His gait, as a rule, unstable, there is claudication and staggering, clubfoot. Often there is an increase in lordosis of the lumbar and compensatory development of the kyphosis of the thoracic segment.
Disability can occur at an early age of the child.
In the absence of treatment in childhood, an adult has a number of diseases due to the progression of dysplasia, as well as the development of osteochondrosis.Extremities when hip function is not able to withstand prolonged exertion. Hypermobility of the thigh leads to a "looseness" of the entire musculoskeletal system. If the congenital dislocation of the hip is not eliminated in time, the joint, adapting to the motor function, can form new contours, both from the acetabulum and the femoral head. The educated new joint is not complete, because it is not able to fully support the support and retraction of the limb;this condition of the patient is called "neoarthrosis".
The most unfavorable complication of is dysplastic coxarthrosis, a disease that develops at the age of 25-35 years and, without an operation to replace the joint, which is the cause of the loss of a person's ability to work.
If the degree of development of the disease is significant, the diagnosis leaves no reason for doubt and is based on an external examination of the child, diagnostic tests, at a later age - in assessing gait, limb shape. Often dysplasia is revealed when the child is examined in the maternity hospital.
Radiographic examination( from 3 months) or ultrasound( from birth) is mandatory. An additional method that confirms the diagnosis is ultrasonography of the joint or MRI.
Treatment of hip dysplasiaThe earlier treatment is initiated, the better the prognostic calculation of the restoration of the function of the joint of the child.
The principle of conservative treatment is that the dislocation and subluxation of the hip can independently straighten itself when the limbs are located and fixed in a dilute state. Up to 6 months of age, the child does not use rigid structures, which in the future can significantly limit the mobility of the joint or lead to necrosis of the femoral head.
The main therapeutic measures:
- Wide swaddling( with 70-80 degrees divorced legs between the legs lay two diapers and fix the third on top).
- The stirrup of Pavlik.
Dysplasia in newborns - signs, treatment
Dysplasia is a disorder of the development of the joint, as a result of which there is a predisposition to dislocation - the exit of the head of the bone from the joint bag. At newly born babies this defect most often affects the hip joints. Dysplasia in newborns is quite common: in some regions of Russia it affects up to 20% of children.
Causes of developmental defects of joints
The musculoskeletal system of the fetus begins to form on the 4th-5th week of pregnancy. This process ends soon after birth, when the baby begins to walk actively. Contrary to popular belief, dysplasia of the hip joints in newborns does not appear due to inappropriate medical practices during labor, but occurs gradually during pregnancy. The most common risk factor is considered to be heredity: more than a third of children suffering from this disease are born in those families where there have already been cases of dysplasia in newborns. The gender of the child also matters: in girls, congenital defects in the development of joints are diagnosed 4 times more often than in boys. Dysplasia often affects the left joint( in 60% of cases), defects in the development of the right joint and both joints simultaneously account for 20% of cases.
Causes of hip dysplasia in newborns can also be:
- Pelvic fetal presentation. If the baby is in the mother's abdomen incorrectly, it prevents him from actively moving. As a result, joint tissues can be formed in such a way that the child will be born with the first stage of dysplasia( the so-called pre-exhalation is a joint state where there is still no displacement of the femoral head);
- Too much or too little birth weight;
- Infectious diseases transmitted by a woman during pregnancy;
- Disturbances in metabolic processes in the mother's body and, as a consequence, violation of water-salt metabolism in the fetus;
- Severe cases of early or late toxicosis;
- Chronic heart diseases that affect the baby's mom.
In the risk group are those children, which inexperienced parents tightly swaddle. In these children, the mild form of congenital dysplasia that is not diagnosed in time can develop in the subluxation or dislocation of the hip joint.
Symptoms of dysplasia in newborns
Until the middle of the last century, defects in the development of hip joints in infants in our country were considered to be only apparently severe forms of dysplasia: dislocations and subluxations. Today, pre-limbs are diagnosed, which makes it possible to avoid serious complications and help the babies born with incorrectly formed joints in time. Therefore, every child in the first days of life examines the doctor-orthopedist. If the baby is at risk or has clinical signs of the disease, the doctor prescribes ultrasound: this method is the most reliable in diagnosing hip dysplasia in newborns aged up to one and a half to two months.
Attentive parents may notice the following signs of dysplasia in the child:
- Limitations of leg budding. At the kid lying on the back, the legs bent at the knees can be diluted so that the angle between the hips is 160-170 degrees( "frog pose").The sign of dysplasia in a newborn is the impossibility of taking such a pose: the affected joint is not fully unbent;
- "Click Syndrome".When bending the legs of crumbs in the knees and hips, a characteristic clicking sound is heard;
- Asymmetry of buttocks and gluteal folds. The baby, lying on the tummy, buttocks have different shapes. The folds on the affected leg are higher than on the healthy one. An additional crease appears on the thigh.
If the mother has noticed at least one of these signs, she should show the child to the doctor. It should be remembered that in the case of a dysplasia in a newborn, the account goes literally for days - the baby needs immediate help, since without it the severity of the disease will increase, and the result may affect the entire life of the child, up to the limitation of mobility and the onset of disability.
Treatment of dysplasia in newborns
For the restoration of full motor functions in children suffering from subluxations or dislocations of the hip joints, manual therapy, massage, physiotherapy procedures, and exercise therapy are used. An experienced manual therapist can adjust the mild form of joint dysplasia in a newborn in several sessions. In such cases, when nursing a crumb, a wide swaddling is recommended: between the legs of the baby is put a folded piece of tissue or a flat pad that gently holds the hip joints in a moderately dilated position. In more severe cases, complex treatment of dysplasia in newborns is used, which takes much longer. In this case, the baby has to wear special "struts"( Feik's feather or Pavlik's stirrups), fixing the legs in the "frog pose", and ensuring the further normal development of the joints. Parents, who seem too cruel to such treatment, do not have to worry: this situation does not cause any inconvenience to the crumb. On the contrary, it is natural for him. By the way, in those regions of the world where it is customary to take babies on their backs with this position of the legs, cases of dysplasia in newborns are relatively rare.
With timely access to medical care and careful implementation of the recommendations of doctors, congenital malformation of hip joints is completely cured during the first 6-12 months of the baby's life, that is, before he starts actively walking. Otherwise, dysplasia in newborns can cause extremely severe joint damage and a serious deterioration in the quality of life of the child.