Hip joint displacement

Treatment of subluxation of the hip joint in children and adults

X-ray of subluxation Hip dysplasia is an inborn inferiority of the joint that results from improper development and leads to a dislocation or subluxation of the femoral head.

The is characterized by three forms of dysplasia: subluxation, pre-dislocation and dislocation.

Stages of

Disease Anterior is the immaturity of an unstable joint that can later develop normally or precede subluxation. At the same time the capsule is stretched, as a result of which the head dislocates and sets into the cavity.

Subluxation is a morphological change in the joint, accompanied by a displacement of the femoral head relative to the cavity in the upward direction to the side. In this case, the contact of the head with the cavity is preserved and it does not go beyond the boundaries of the limbus. With proper treatment, the joint can return to its full state, otherwise there is a possibility of a complete dislocation.

Dislocation of is characterized by a complete displacement of the femoral head and is the most severe form of joint dysplasia. With it, there is a violation of the contact of the articular surfaces of the bones with the violation of the joint capsule and without it due to mechanical influence or pathological processes in the joint. Dislocations are complete and incomplete. Dislocated is the farthest from the trunk part of the limb.

Classification of subluxations

Dislocation of congenital is the most severe form of the disease and is characterized by a complete displacement of the femoral head. This stage of dysplasia is detected at the time of the birth of the child, to develop as a result of incorrect treatment or lack of it at all. The cause of the disease is heredity, a pathological condition during pregnancy, or clinical signs of joint instability.

The subluxation of the acquired develops as a result of the swaddling of children, the use of restrictive child seats or the cradle with hip joint blockage for a long time.

The cause of the pathology is the genetic factor or the narrow uterus, which contributes to the displacement of the joint during intrauterine development.

Symptomatology of the pathology of

Symptoms of subluxation of the hip joint can be assumed even before the birth of the child. Pelvic presentation, toxicosis in pregnancy, dysplasia in the parents, deformity of the feet or a large fetus should be alerted in terms of a possible disease. Even if orthopedic symptoms are absent, children are still referred to the risk group.

Allocate 4 groups of clinical features of subluxation of joints:

  • truncated thigh;
  • asymmetry of skin folds;
  • symptom of the sliding of Marx-Ortholani and the modification of Barlow;
  • limitation of the hip.

Upon inspection, attention is drawn to a detail such as symmetry of the skin folds of .Moreover, asymmetry is more informative in 2-3 months after birth. Buttocks, inguinal and popliteal folds are deeper and their number is larger.

The femoral shortening phenomenon is an important diagnostic criterion, characterized by a hip shortening due to posterior displacement of the femoral head in the acetabular region. He points to a congenital subluxation of the hip joint and is confirmed by the fact that if a child who lies on his back in a position with bent knees and hip joints, one knee is located below the other.

Symptom of Marx-Ortolani - it can be determined with the help of subluxation only up to 3 months, after which it disappears. It is defined as follows: the legs of the baby bend at the knee and hip joint at right angles, then are led to the middle line and gently bred to the side. From the side of the dislocation you can hear it like a click, in which the baby's leg jerks.

Diagnosis of

The diagnosis of "subluxation of the hip joint" is primarily based on clinical symptoms, as well as the results of ultrasound and x-ray.

  • Screening of newborns - most countries use it when diagnosing a subluxation of the hip joint in newborns.
  • Another way to find out about the disease is the method of Marx-Ortholani .If a click or dull sound is heard during the examination in the area of ​​the thigh, additional methods are used to clarify the diagnosis and the cause of the disease.
  • Methods of Ortholani and Barlow are diagnostic methods for newborns used in modern medicine.
  • Ultrasound and X-ray examination are secondary diagnostic methods after clinical signs. With their help you can visualize anatomical features.
  • The asymmetry of the buttock folds of the and the apparent difference in the length of the lower limbs may indicate unilateral dysplasia.
  • Assessment of the hip by Harris is one of the main ways to assess the normal operation and function of the joint after surgery.
breeding of baby legs A doctor-orthopedist should be suspected in time and diagnosed with a disease when examining a newborn child in the maternity hospital. After that, the risk group or sick children are observed by the orthopedist at the place of residence. Assign a special orthopedic treatment of , which is continued until the final diagnosis is made.

The final diagnosis of is based on visual examination, the results of instrumental diagnostic methods and ongoing monitoring of the child.

Techniques and devices that are used to treat

The following standard methods are the main principles of treatment:

  • early start;
  • application of special orthopedic means for prolonged retention of legs in the position of bending and withdrawal;
  • exercises and movements in the hip joints.
It is impossible to start the disease, since the subluxation of the hip joint in adults is practically not treatable due to the established position of the joint bones relative to each other.

In the treatment of subluxation of the hip joint in children with or without a head hip displacement, various types of pillows, tires, panties,

fixing the legs stirrups and other devices are offered. Their goal is to keep them in the position of breeding their legs, providing them with the function.

In children less than 3 months of age, there are enough clinical symptoms to confirm the diagnosis, an X-ray examination is not required. All children of this age are prescribed the same measures of medical and prophylactic direction - leg breeding with ( wide swaddling, Pavlik's stirrups, elastic tires or Freik's pillow), gymnastics - off-center movements in the joint and massagegluteus muscles.

At a small age, it is unacceptable to use rigid structures - tires that impede the movement of limbs.

Basically for the treatment of congenital subluxation of the hip joint is used:

  1. pillow of Freik;
  2. tires Volkov or Vilensky;
  3. of the Pavlik stirrup;
  4. wide swaddling - used for prevention and light degrees of subluxation;
  5. one-stage dislocation and coxitic dressing - used in especially severe cases.

To determine exactly how to treat a subluxation of the hip joint and what structures the child should be prescribed by the attending physician.

When the operation

is prescribed If there is no positive effect from the treatment with conservative methods, corrective operations are used. For the treatment of joint dysplasia is used a variety of surgical methods of :

  1. dislocation direction open;
  2. for the degeneration and corrective varising osteotomy;
  3. pelvic surgery - a method of osteotomy of the pelvis by Chiari;
  4. palliative operations( Koenig and Shantz).

Conservative treatment methods are effective in childhood. The older the person, the more likely it is that surgical intervention will help get rid of the disease.

Inflammation of the kneeIncreasingly, Schlätter's disease in children began to be diagnosed. What are the causes of pathology and methods of treating the disease? Read in our article. Why dysplasia of the hip joints in newborns should be detected within three weeks after the birth of the child, you can find out here.

Possible complications of

Early diagnosis and properly prescribed treatment will help to avoid complications, you can completely get rid of the disease. Some people, in addition to external defect and lameness, do not experience any symptoms and signs of the disease.

In others, on the contrary, without timely therapy there can be serious consequences of .In addition to limping, there may be pain in the knee and hip joint area, there is a skewed bones of the pelvis or a pronounced muscle atrophy of the limb. In rare cases, the lumbar spine suffers( hyperlordosis), the functions of the pelvic organs decrease, the pelvic and pelvic bones ache.

Preventive measures

To avoid the appearance of the disease or its further development, regular check-ups with the orthopedist are necessary. Wide swaddling is one of the effective preventive methods of subluxation of the hip joint in a newborn.

Its essence lies in the fact that two diapers to lay between the legs of the baby and give the position of bending or tapping the legs in the hip joints, and the third diaper to fix the legs. Wide diaper keeps bending and breeding position at 60-80 degrees.

Video: How does a subluxation of the hip on the x-ray look like

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Hip dysplasia in a child

Dysplasia is a congenital disease in infants that consists of incorrect, inferior development, displacement, asymmetry of all elements of the hip joint. Dysplasia often accompanies the disruption of the entire musculoskeletal system, including the spine in the cervical, thoracic and lumbar regions, which is manifested in the curvature and scoliosis. Timely treatment, comprehensive approach and patience make it possible to correct almost all the listed consequences.

Hip dysplasia in newborns may be as follows:

  • Anterior - minor changes in the head of the hip or acetabulum. Independently in infancy it is rather difficult to consider the deviations that are visible by incorrect placement of the foot and curvature of the spine. The prefest is characterized by a free stroke inside the joint of the femoral head, weak periarticular ligaments.
  • Subluxation - displacement of the femoral head in different directions within the cartilage part of the joint.
  • Dislocation of is the most rare and difficult case to treat when the head of the thigh can freely pop out of the acetabulum.

It is important that the first two degrees of disease without proper treatment smoothly flow into serious dislocation and health problems of the child for life. That is why it is necessary to take extremely cautious attitudes to the examinations of the baby and at the first suspicions to carry out the diagnosis.

Dysplasia in newborns - the causes of

Precisely no one will say why a child was born with the pathology of the joint. Influences on the wrong development of the hip joint can be influenced by factors such as:

  • Heredity. If the direct relatives suffered from the disease, there is a high probability of taking it to the child.
  • Gluteal presentation of the fetus, since the load on the joints of the hips during labor is great. It can also include cord wrapping with the umbilical cord, the close position of the child in the mother's womb, and water scarcity aggravates the situation even more.
  • Birth complications, trauma to the baby.
  • Toxicosis, and as a result, the lack of vitamins and trace elements necessary for the proper development.
  • Age of the woman, especially when the first child is born. The older the mother, the higher the risk of dysplasia in the baby.
  • Infectious diseases or hormonal disorders transferred during pregnancy.

Symptoms of hip dysplasia in children

Symptoms of dysplasia are expressed in varying degrees and are often seen with the naked eye. Regular examination by doctors and attentive attitude to their own child will allow timely detection of a deviation.

So, the external manifestations of dysplasia are as follows:

  • Asymmetric location or different number of wrinkles on the buttocks and hips of the child;
  • One or both feet, turned outward or inward;
  • Different length of legs;
  • Incomplete or obstructed dilution of the legs of the toddler;
  • Frequent head position on one side;
  • Curvature of the spine( strong flexure in the lumbar region);
  • Syndrome "click", that is, a characteristic sound, indicating the direction of the joint due to this or that movement of the child's thigh.

The presence of one or more of the symptoms on this list is a good reason to conduct a medical examination of the baby. The final diagnosis is made only after ultrasound( in children up to 6 months old) or X-ray( for children over 6 months old).

Methods for treating dysplasia in children

The treatment of dysplasia should be treated with the utmost responsibility. The period of treatment is quite long, the process includes a variety of techniques aimed at correcting and correct ripening in children of the hip joint. Rehabilitation complex can include both standard and non-traditional approaches.

Traditional treatment is to fix the joints in a certain position, the baby's legs should not be reduced and divorced to avoid bias. The correct position of the joints is held by the following methods:

  • A wide swaddling performed with three diapers. The first is formed by a rectangle in several layers up to a size of 15-20 cm in width and placed over the diaper or without it between the legs, which are divorced at right angles to the trunk. The second diaper is made with a kerchief, the lower edge is fixed with the diluted legs and fixed. The third baby freely turns around to the waist, holding the legs in a fixed state.
  • The Freck pillow is a rigid base, sewn into a soft fabric, equal to the distance from one knee hollow to the other;it is put on top of clothes.
  • Tires and stirrups, orthopedic pants.
  • Therapeutic gymnastics, which a specialist should do to avoid even greater injuries.
  • Surgical intervention, is prescribed only in the most severe cases of dislocation.

These devices are prescribed from the first days of life, use is discontinued on the recommendation of a doctor at the age of 6 to 12 months.

  • When dysplasia pediatricians recommend doing massage to the child, in this thread you will find out what massage techniques exist.
  • Since the first days of life, it is necessary to increase the immunity of the child, because many diseases depend on him. In this topic, you will learn how to increase the body's resistance to various infections.
  • In the detection of this disease, it is recommended that the child of the first days of life swaddle widely, and how to correctly do this in this publication.

An unconventional method of treatment of dysplasia is manual therapy. In this case, no orthopedic adaptations are used and the child's movements are not limited. There is a treatment in this way: with the help of hands, a dislocation or subluxation is eliminated, the adjacent pelvic and spinal muscles relax by massage to avoid joint displacement, a complex of gymnastics is being developed to strengthen the periarticular ligaments.

The decision on how the treatment will be administered should be taken in conjunction with the attending physician, because the success of the child's recovery depends on this. The presence of dysplasia should not be a hindrance to the knowledge of the world around him, let the kid communicate with other children, try, touch objects, walking is mandatory. Do not be shy, there is nothing terrible here. Dysplasia of the hip joint is unpleasant, but with early diagnosis and proper treatment, there will be no trace of the disease with time.

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Symptoms of dysplasia in newborns:

  • folds of the buttocks are not asymmetric. They are higher than usual;
  • lower limb shortened;
  • is a click sound that says that the head of the hip bone slides into the acetabulum;
  • the head of the thigh loosely moves down and up;
  • restriction in the femur;
  • the head of the hip bone is displaced if the leg is bent in the region of the hip joint.

Detecting dysplasia in a child and all relevant symptoms at home. Mom should examine the legs, compare the folds on the legs and notice that one leg of the baby is shorter than the other. Or to sound an alarm if the child tries to start walking and at the same time limps. The most important thing is to immediately consult a doctor who will determine the severity of the pathology and the degree of dislocation and prescribe the treatment.

Symptoms of dysplasia in an adult:

  • sharp hip pain;
  • shortened limb;
  • impossibility to move a limb normally, a feeling of severe pain with the slightest movement;
  • edema.

Restriction of leg leads is usually diagnosed in children up to a year.

Classification of

Dysplasia, that is, dislocation of the joint, can be manifested by subluxation, pre-prelum and dislocation. All depends on how much the head of the femur has shifted relative to the acetabulum.

If a subluxation of the femur has occurred, the joint head is pulled back. If you do an x-ray, you will see that the acetabulum and the neck of the femoral head are chamfered. This type of dislocation is often caused by accidents, since the person who sits in the car, during a strong impact and braking, strikes hard because of a sharp shift of the body forward. As a result, the femur is displaced backward. Sometimes an operation and an endoprosthesis installation is necessary, if the blow is very strong and the bone as a result is broken or fractured. If possible, the doctor will fix the advanced bone.

Subluxation of the femur is characterized by a shift of the femoral head upwards and outwards. As a result, it turns out that the head of the hip bone and the acetabulum are at different levels. In this case, the limb can be bent in the knee region and turned outward, and the front part of the capsule of the head - rupture. A person can not move unless the nerves are touched and torn, the feet are numb.

In case of dislocation, the head of the hip bone strongly shifts up and out, there is no contact between the head and the acetabulum. Dislocation is the most severe form of damage to the hip joint, as the bones break. It is necessary to perform the operation and it is possible to install an endoprosthesis. The bones of the acetabulum are capable of fracturing, and the head of the hip bone is displaced into the pelvic region. Symptoms are as follows:

  • unbearable severe pain;
  • the limb is completely immovable.

After the operation, a person will have to undergo treatment, a long recovery period and rehabilitation before he again starts to walk and move normally. Often, an operation is performed, during which the implant is installed an endoprosthesis, if the hip bone is severely damaged and will not recover.

Therapeutic measures

Treatment of dislocations consists in the speedy rehabilitation, it is necessary to fix the joint and fix it. During the rehabilitation period, the doctor prescribes functional treatment( exercise therapy and physiotherapy).

Treatment of congenital dislocation of the hip is long( usually from one month to one year).

If there is an extension of the ligaments of the hip joint, the femur will need to be inserted. Methods of hip adjustment:

  • by Janelidze method( posterior and anterior dislocation);
  • by the method of Kocher-Kefer( anteroposterior oblique dislocation).

The prognosis after a timely dislocation of the dislocation is good. Complications usually occur in violation of blood circulation: developing disfiguring osteoarthritis and aseptic necrosis of the femoral head.

The consequences of the pathology that occurred at an early age, completely depend on the beginning of treatment. If the dislocation is not eliminated, the outcome will be dysplastic coxarthrosis, which has developed to about 25 years. Symptoms are as follows: the patient will feel constant pain, restriction of movements in the joint. An untreated subluxation of the hip joint will give lameness, pain, which will manifest in the child already to 3-5 years. The consequences of unresolved pathology in any case lead to disability of the patient. The endoprosthesis may be a chance, but it is better to start treatment earlier, so that the child normally walks.

Treatment methods

Treatment of congenital dislocation of the hip is based on two directions:

  • Conservative therapy.

An individual tire is selected for the child, which keeps his legs retracted and bent in the hip and knee joints. In time, the "delivered" thigh head in the acetabulum leads to a normal development of the joint. Treatment is particularly effective at the earliest start( up to 3 months).At the end of therapy, the symptoms go away.

  • Operative treatment.

Effective for a child under 5 years of age. The older the baby, the more difficult it will be to eliminate the pathology without consequences. For children who have not reached adolescence, only intra-articular interventions with a deepening of the acetabulum are shown. Adult patients and adolescents perform extra-articular operations, a "roof" of the acetabulum is created.

The installation of an endoprosthesis for various types of pathology is indicated only in severe or neglected cases and with a dislocation with pronounced impairment of joint function. The presence of an endoprosthesis, unfortunately, can cause complications. Dislocations and subluxations sometimes occur after the installation of the endoprosthesis.

Scheme of therapy

If the pathology is not treated - it can lead to disability of the child.

In newborn infants, subluxation of the hip can be cured in two ways:

Non-surgical method. Conservative treatment is most often carried out using a tire that is selected specifically for a particular patient. Using the tire, the legs of the newborns are held at right angles in a bent state with retraction in the joint. Thanks to the adaptation, the joints begin to return to normal and subsequently form correctly. This method of treatment is the most common and effective. But provided that it is started to be applied on time, as the earlier treatment is carried out, the faster the head of the femur will enter the acetabulum. The best time for such treatment is the first days of life of newborns.

Operational. It is carried out under the condition that conservative treatment is not started within three months after the birth of the child, and the subluxation has passed into the formed dislocation.

The scheme of treatment of subluxation of the hip joint is as follows:

  • Newborn babies up to a month should be swaddled widely. The method of wide swaddling is that the diaper is folded in the form of a rectangle about 15 cm wide and placed between the legs of the baby.
  • Therapeutic gymnastics for children is quite an effective way in addition to the first. Carry out gymnastics every time you change a baby diaper: plant the legs in different directions.
  • It is necessary to undergo physiotherapy, massage, swimming.
  • If all these methods did not help to defeat the congenital defect, the doctor will consider it necessary to advise using orthopedic devices. The most simple and sparing for the child way is to use the Pavlik stirrup at the age of three weeks to nine months. Stamens fix the legs in a bent state in the region of the hip and knee joints at an angle of 90 degrees.
  • If the dislocation was not detected in newborn infants at once, then it is necessary to use a tire with tutors, starting from six months. If the doctor allows the child to walk, then a specially designed tire is used for this. The tire should be checked and adjusted weekly so as not to be cramped, as the toddlers grow quickly.
  • Closed direction of the head of the hip joint is used when all other methods have no positive effect. Manipulation under general anesthesia is performed. The bottom line is that the doctor lifts his foot up, and then pulls it aside. After manipulation, immobilization with a special plastic skeleton is necessary for six weeks. Then the doctor conducts an examination. With positive dynamics in children, the skeleton is used for another three months.
  • If the examination shows that the result is negative, there is no positive dynamics and the subluxation is preserved, then a surgical procedure is performed.

Sometimes, both hip joints can be affected in children. If the process is started, then the subluxation passes into a dislocation, and then the head of the femur generally exits from the acetabulum. A kid can not crawl, walk, and when he grows up, he will become lame. Therefore, do not delay the visit to the doctor and begin treatment on time!

As for adults, it is not worth delaying with surgery and treatment, as this can lead to disability. After all, over time, the bones are deformed and getting rid of dysplasia becomes very difficult or even impossible.

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Hip dysplasia in a child: what parents need to know |Pediatrics

Presence of the listed risk factors should be an occasion for observation at the orthopedist and carrying out of preventive measures( wide swaddling, massage and gymnastics).

Alarming symptoms of

There are five classic symptoms that help to suspect hip dysplasia in infants. Any mom can detect the presence of these symptoms, but only the doctor can interpret them and draw conclusions about the presence or absence of dysplasia.

  1. Skin fold asymmetry .The symptom can be checked by putting the child on the back and maximally straightening the jointed legs: the inner surface of the thighs should be marked by symmetrical folds. When unilateral dislocation on the affected side, the folds are higher. In the position on the abdomen, pay attention to the symmetry of the gluteal folds: on the side of the dislocation, the gluteal fold will be located higher. It should be borne in mind that asymmetry of skin folds can be observed in healthy infants, so this symptom is given importance only in conjunction with others.
  2. The symptom of sliding ( click, Marx-Ortholani) is found almost always in the presence of hip dysplasia in newborns. The diagnostic value of this symptom is limited by the age of the infant: it can be detected, usually up to 7-10 days of life, rarely it lasts up to 3 months. When you bend the knees bent at the knee and hip joints, you hear a click( the sound of repositioning the head of the femur).When the legs are brought together, the head leaves the joint with the same sound. The symptom of a click indicates the instability of the joint and is already determined at the initial stages of dysplasia, therefore it is considered the main sign of this pathology in newborns.
  3. is the second most reliable symptom of dysplasia. When the knees bent at the knee and hip joints, the legs are resisted( normally they are bred without effort to the horizontal plane by 85-90º).This symptom is of particular value in the case of a one-sided defeat. Limitation of the lead indicates pronounced changes in the joint and with mild dysplasia is not determined.
  4. The relative shortening of the lower extremity of is detected with unilateral lesions. Lying on the back of the child bend the legs and put the feet on the table. Shortening of the hip is determined by different height of the knees. In newborns this symptom is found only at high dislocations with a shift of the femoral head upwards and is not determined at the initial stages of dysplasia. He has great diagnostic value after 1 year.
  5. External turning of the thigh .As a rule, this symptom is noticed by the parents during the baby's sleep. It is a sign of a hip dislocation, and is rarely detected with subluxations.

Diagnosis of hip dysplasia

The neonatologist in the maternity hospital examines the first for the presence of dysplasia in the maternity hospital and sends a consultation to a pediatric orthopedist if symptoms are found that indicate a violation of hip joint formation. An examination of a pediatric orthopedist or surgeon is recommended to be performed at the age of 1, 3 and 6 months.

The most difficult is the diagnosis of prelum. When viewed in this case, the asymmetry of the folds and the click symptom can be detected. Sometimes external symptoms are absent.

With subluxations, asymmetry of the folds, a click symptom and restriction of the hip abduction are detected. In some cases, there is a slight shortening of the limb.

Dislocation has a more pronounced clinic, and the symptoms of pathology can be noticed even by the parents.

Additional diagnostic methods are used to confirm the diagnosis - ultrasound and radiography of the hip joints.

Ultrasound examination of the hip joint is the main method for diagnosing dysplasia up to 3 months. The most informative method is at the age of 4 to 6 weeks. Ultrasound is a safe method of examination in connection with which it can be prescribed as screening at the slightest suspicion of dysplasia.

Indication for the passage of ultrasound of the hip joints to 4 months of age is the detection of one or more symptoms of dysplasia( clicks, limitations of hip abduction, asymmetry of folds), a burdened family history, breech delivery( even in the absence of clinical manifestations).

Radiography of the hip joints is an affordable and relatively inexpensive method of diagnosis, however, to date, it is used limited in connection with the risk of exposure, and the inability to display the cartilaginous head of the femur. During the first 3 months of life, when the head of the femur consists of cartilage, the radiograph is not an accurate method of diagnosis. From 4 to 6 months of age, when ossification nuclei appear in the femoral head, radiographs become a more reliable way of detecting dysplasia.

Radiography is used to assess the joint condition in children with a clinical diagnosis of hip dysplasia, to monitor joint development after treatment, and to evaluate its long-term outcome.

It is not necessary to refuse to pass this examination, fearing the harmful effect of X-ray irradiation, since unidentified dysplasia has much more severe consequences than X-rays.

Treatment of hip dysplasia

To date, the main principles of conservative treatment of hip dysplasia are:

  • Early onset of treatment;
  • Giving the finiteness of the position that helps to correct( flexion and hip withdrawal);
  • Preservation of active movements;
  • Application of additional methods - medical gymnastics, massage, physiotherapy.

The effectiveness of conservative treatment is assessed using ultrasound and radiography of the hip joints.

The standard regimen for the treatment of hip dysplasia includes: wide swaddling, massage and exercise therapy for up to three months, Pavlik's stirrups( Gniewkowski's apparatus) for up to 6 months, and later - outgoing tires in the presence of residual defects. In the diagnosis of dislocation after 6 months sometimes first resort to adhesive tape with subsequent fixation of the joint in the outgoing tire.

The duration of treatment and the choice of orthopedic devices depends on the severity of dysplasia( pre-injury, subluxation, dislocation) and the patient's age. When appointing Pavlik stirrups or other devices, it is important to follow the recommendations of the attending physician and observe the mode of wearing them. As a rule, in the first two weeks, stirrups must be worn constantly, taking off only for the time of evening bathing.

LFK for hip dysplasia is used from the first days of life. It strengthens the muscles of the affected joint and contributes to the full physical development of the child. Massage begins at the age of 7-10 days, it prevents dystrophy of the muscles and improves the blood supply to the affected joint, thus contributing to the acceleration of recovery.

Physiotherapy treatment includes electrophoresis with calcium chloride, cocarboxylase and vitamin C, paraffin applications on the hip joint area, ultraviolet irradiation, and vitamin D preparations.

It should be noted that massage, exercise therapy and physiotherapy at each stage of treatment have their own characteristics. Therefore, they must be used only under the supervision of the attending physician.

Surgical treatment is used after the child reaches the age of 1 year. Indications for surgery are true congenital dislocation of the femur in the absence of the possibility of conservative repositioning, repeated dislocation after closed repositioning and late diagnosis( after 2 years).

A child with a congenital hip dislocation should be on the dispensary record with an orthopedist before the age of 16.

It is important to understand that dysplasia of the hip joints in infancy can be corrected in a few months, but if it is not cured in time - the correction of violations in the older age will take much more time and effort. To prevent severe consequences of dysplasia, you only need to follow the doctor's recommendations.

Author: Orthopedic Trauma Physician Kononov Valery Stepanovich

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