Hemorrhage of the hip joint in the infant: treatment

All about the immaturity of the hip joint in newborns

The immaturity of the hip joints occurs in 20% of newborns. In medicine, this phenomenon is also called dysplasia.

Under this pathology, orthopedists and related specialists are referring to congenital abnormalities in the development of joint structures and their inferiority (underdevelopment). Type 2a according to the Graph (ultrasound classification) is an immature dysplastic joint.

The initial stage is pre-exertion, and if you do not respond and start treatment in time, the pre-exacerbation will have dangerous consequences: subluxation or dislocation of the hip head in children.

Dysplasia of the hip joints in newborns is the most commonly pronounced diagnosis in the orthopedic department

Anatomy of pathology

Even in absolutely healthy children who have just appeared, the structure of TBS is not a fully formed structure (immaturity), and there are possible problems associated with it.

The system of ligaments in children has such differences from adult TBS:

• The newborns have a large vertical articulation of the articular cavity.
• In newborns, ligaments are more elastic.
• In newborns, 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.

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 pathology of the acetabulum).

Immature dysplastic joint of newborns (type 2a according to the Earl) is 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.

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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.

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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 malformations of bone development in the proximal part (underdevelopment) are changes in the neck-diaphysial 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 likely 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.

Risk areas

Congenital immaturity (immaturity) of the joints in children can be a consequence of how the mother's pregnancy has progressed, so the following factors influence the occurrence of pathologies:

1. Treatment with potent drugs during pregnancy.
2. Acute leaking toxicosis.
3. Malnutrition, beriberi.
4. Presence of chronic diseases in pregnant women.
5. Family predisposition.
6. The first birth.
7. Very large fruit.
8. Pelvic presentation of the fetus.
9. Early labor (immaturity of the mother's body).
10. Preterm birth (prematurity of the fetus).

Grudnichkov, who are in the risk zone, immediately put on the account of an orthopedist and begin treatment.

Pregnant women in the case of a large fetus or his wrong presentation usually appoint a cesarean section.

Natural births are dangerous for their possible consequences: when the fetus passes through the birth canal, its weak hip joints can also be broken.

Significantly affects the probability of dysplasia and sex of the child.

In female babies, ligaments have a higher elasticity, which leads to a greater risk of "instability" of the head of the hip joint in the acetabulum.

Stages, diagnosis and disposal of the disease

The stages of dysplasia include preluxation and subluxation of the joint - underdevelopment (immaturity) hip joint without bias or with a slight displacement of the femoral head relatively acetabulum. The most difficult form of dysplasia is dislocation of the bone. Dislocation causes tenderness in walking and gait changes in children (clubfoot, limp and other flaws).

Anterior, subluxation and dislocation are revealed through visual inspection and application of modern technologies. The clinical manifestations of immaturity of the hip joint can be noticed by an orthopedic physician or the parents themselves.

To treat the disease, massage and the use of various orthopedic devices are prescribed.

Symptoms and treatment of immaturity of different stages:

1. Pre-exerted.

Symptoms of the initial stage of pathology in newborns are poorly expressed (see the photo or video - children with pre-invisibility can hardly be distinguished from babies without pathology of the hip joints).

Asymmetry of skin folds on the legs and buttocks is not observed. The legs of a newborn do not differ in size from each other.

At the initial stage of immaturity may indicate the following: if you put the newborn on the back and bend the legs to dissolve a little to the side, you will feel a slight push and perhaps a slight crunch - this head of the thigh enters the acetabulum hollow. If this symptom is found, you should immediately consult a doctor for a more accurate diagnosis. The pathology is completely correctable even by simple conservative methods:

• Massage.
• Healing charge (with a coach or a special video at home).
• Electrophoresis.
• Wide swaddling of newborns.

2. Subluxation.

The main signs of subluxation are as follows:

• Asymmetry of skin folds in the region of the legs and buttocks of the newborn.
• Limitation of the angle of the legs.
• Different length of legs or different height of knees when bending legs.
• A characteristic click during the breeding of the legs to the sides (a sliding symptom according to Marx-Ortolani).
• Anxiety of the newborn during movement, loss of sleep and appetite.

Suspicions of subluxation obtained during examination should be confirmed by ultrasound. Exhaustive indicators give ultrasonography. X-rays are used only when the baby reaches the age of three months.

With subluxation, as a rule, prescribe treatment with conservative methods: massage, gymnastics, electrophoresis. Surgical intervention is mainly recommended only in difficult cases of dislocation.

With the underdevelopment of TBE in a baby, a good result is a massage.

To correct subluxation, infants and older children are prescribed orthopedic devices:

1. Pillows of Freik.
2. Becker's special trousers.
3. The stirrup of Pavlik.
4. Tires of Vilensky or Volkov.
5. Cosmetic bandage.

The action of these devices is aimed at fixing a stable position in order to get rid of the subluxation, allowing the joint to become stronger and to ligament.

3. Dislocation.

Symptoms of dislocation are similar to those of subluxation, only more pronounced - asymmetrical skin folds, limited amplitude of motion in the joint, different length of legs, etc.

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For the treatment of dislocation, one-stage restorations of the hip joint can be applied. In most cases, a surgical corrective intervention is prescribed, although this is an extreme measure.

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After successful adjustment of the dislocation, the doctor prescribes a course of restorative procedures, which includes electrophoresis, therapeutic massage and a complex of physical exercises that moms can do on their own (use the advice of experts from video training that will allow you to choose the right ones exercises).

Features of health procedures

The most common treatment procedures that are used in parallel with drug treatment for dysplasia in newborns are:

1. Massage.
2. Wellness gymnastics.
3. Electrophoresis.

If there are a lot of articles and reviews written about the first two procedures, then the last procedure is lightly scant - we will dwell on it a little more in detail.
Electrophoresis is a physiotherapy procedure, as a result of which small impulses of the current are applied to the patient's skin.

Since the current passes through the cheesecloth moistened in the medicine, the skin enters the epidermis through the skin, and then, together with the blood, it enters the desired part of the body. The procedure is completely safe and therefore suitable even for infants.

To treat dysplasia, the electrode plate is applied to the gluteus muscle. As a medicine, euphyllin, dissolved in pure distilled water or dimethoxide, is used. Electrophoresis normalizes blood circulation in the tissues surrounding the joint, saturates them with nutrients.

It is important that immaturity (dysplasia) of the hip joint in newborns is identified at the earliest stages. The faster the orthopedist will prescribe the treatment, the more effective it will be.

A source: http://ProKoksartroz.ru/displazija/nezrelost-tazobedrennyh-sustavov-u-novorozhdennyh

Immaturity of the hip joint in newborns: causes, symptoms, gymnastics

The greatest joy for all couples is the birth of a child. But the happy moments of the first days of a baby's life can be overshadowed after a visit to the orthopedist.

It is on the admission of a specialist that parents first learn about such a pathology as the immaturity of the hip joint in newborns. Often, the doctor mentions dysplasia.

Such a verdict can scare everyone without exception. Should he really be afraid?

Immaturity of pelvic bones and dysplasia: what is the difference

Under the immaturity of the pelvic bones is understood their slow development, and dysplasia is initially an incorrect formation of the joint. These two states are often confused.

Until recently, both pathologies were united under one term "dysplasia". Today there is a tendency to differentiate concepts, which in itself is already good.

Correctly formulated diagnosis allows you to choose the most competent treatment, if it is required.

When it comes to babies, the term "dysplasia" should be understood as the immaturity of the hip joint.

In newborns, this pathology is considered physiological, so it does not need serious treatment. However, you should not completely ignore this problem. Timely detection of a violation and its correct correction allow avoiding complications in the future.

The main causes of pathology

There are several factors, the presence of which determines the risk group for the development of this pathology.

Before talking about them, it is necessary to explain how and why immaturity of the hip joint occurs in newborns.

At present, science offers several theories about the etiology of the disease. One of them should be considered in more detail.

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For some time before the forthcoming births, the female organism begins to intensively produce the hormone relaxin.

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Its main purpose is to soften the femoral-sacral joints of the future mother. He also makes the pelvic bones of a woman more mobile.

However, relaxin does not work selectively - by affecting the bones of the mother, it also softens them in the fetus.

If a woman has well-formed ligaments, she does not risk getting a dislocation during or after childbirth. As for the child who was born, the situation is different.

According to statistical data, in 25% of newborns, doctors diagnose the immaturity of pelvic bones.

As a rule, the joints are restored on their own. But if they do not come to anatomical rate, a minor correction of the problem is required.

Among the factors contributing to the emergence of immaturity of the hip joints in newborns, it is possible to relate:

• first birth;
• very large fruit;
• the birth of a girl;
• pelvic presentation;
• hereditary predisposition.

Grudnichkov, a member of the risk group, immediately after birth is registered with an orthopedic surgeon and begins correction of the disorder.

Symptoms of immaturity of the hip joints of newborns

All the symptoms of the pathological process can be divided into two conditional groups.

The first are the signs that only an experienced doctor can diagnose, and the second one is available for parents' understanding.

To draw conclusions about the presence of ailment exclusively on external deviations is erroneous. However, parents should visit an orthopedic surgeon if they have the following symptoms:

1. Asymmetry of inguinal, femoral and gluteal folds.
2. The knees are at different heights. If you put the child on his back, straighten his legs and bend in the knees, the latter should be about the same level. Otherwise, you should think about the presence of pathology.
3. Different amplitude of joints. The child must be put on his back and bend his legs in his lap. Normally, in newborn children, limbs have high flexibility, so you do not need to exert any effort. If the amplitude of one thigh is significantly different from the other, it is urgent to show the child to the doctor.

Timely identified immaturity of the hip joints of the newborn increases the chances for a quick recovery of the baby.

To what doctor to address?

The detection of one or all of the signs of an illness does not at all mean that the child has health problems.

On the other hand, lubricated symptomatology is not a guarantee of the lack of immaturity of pelvic bones. After all, pathology can also be bilateral.

In this case, the asymmetry of inguinal or gluteal folds should not be present.

From all of the above, it can be concluded that with any suspicions it is necessary to contact a pediatric orthopedist who will diagnose:

1. It begins with a questioning of the mother. The doctor should know how the pregnancy went, whether there were complications, whether there is a genetic predisposition to the disease.
2. Ultrasound of the extremities. This method is completely safe for health, but at the same time is characterized by high informativeness. With his help, the doctor can tell exactly whether the baby has immaturity of the hip joint.

In neonates, the size of the ossification nucleus is measured during ultrasound. This indicator should correspond to the age of the patient. Even a slight deviation from the norm may indicate a pathological process.

Correction violations

The physiological immaturity of the hip joints in newborns is not a reason to fall into despair. Such a diagnosis is not deadly, but it is not necessary to neglect it either.

In the early stages, pathology can be perfectly adjusted. To stimulate the proper development of joints use special tires.

However, this method of therapy is not suitable for children who are already 6 months old.

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Without fail, small patients are prescribed vitamins. The duration of the course, the specific remedy and its dosage is determined by the doctor.

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Treatment of pathology is also impossible to imagine without special massage and physiotherapy procedures.

If in the first case, specialists can not do without qualified help, then paraffin-based applications can be performed at home. How to properly and without damage to the health of the child to do the procedure, the doctor should tell.

Physiotherapy

What other methods of treatment are used in the diagnosis of "immaturity of the hip joint in newborns"? Gymnastics is an integral part of correction of limb development. The therapeutic complex is selected individually, but usually it consists of the following exercises:

• "a bike
• rotational movements of the legs;
• dilution and reduction of legs in the hip joint.

Such exercises are recommended to be repeated every time you change a diaper. In this case, the child must be laid on a flat surface. A bed or a soft sofa for these purposes are not suitable.

Gymnastics with immaturity of the hip joints in a newborn does not require special skills. However, it will still be better if the orthopedist will show how to do the exercises correctly.

Wide swaddling

Many parents probably heard about the technique of wide swaddling. In fact, only some of them know what it is. Wide swaddling is used to treat and prevent the immaturity of pelvic bones, but it is performed as follows:

1. It is necessary to fold the usual fabric diaper with a triangle, pointing its base downwards.
2. The baby can wear a diaper.
3. The child should be put on the prepared diaper, bending his legs about 80 degrees.
4. After that, the ends of the tissue should be wrapped around the extremities of the newborn, and the base of the triangle is fixed on the abdomen.

This position of the "frog despite the complexity of swaddling, is very convenient and useful for the baby.

Preventive measures

How can we prevent the immaturity of the hip joints in newborns? Treatment and correction of this pathology requires a lot of time.

If you do not notice the problem in the first weeks of the baby's life, you can face negative consequences.

That is why many parents are interested in the issue of preventing the immaturity of pelvic bones.

To reduce the risk of developing pathology helps the correct course of pregnancy. First of all, it is necessary to exclude the effect of negative factors on the fetus.

A balanced diet of the mother also plays an important role in the prevention of the disease. And if she has an increase in the tone of the uterus, it is important to take steps to eliminate it.

Medicines are prescribed for these purposes.

What kind of drug to use, the doctor-gynecologist decides. Self-medication can not be done. In addition, it is advisable to check the development of the hip joint of the baby still in the hospital. If a pathology is found, you should immediately start to treat it, and the baby will be healthy.

A source: http://.ru/article/259558/nezrelost-tazobedrennogo-sustava-u-novorojdennyih-prichinyi-simptomyi-gimnastika

Physiological immaturity of the hip joint in newborns (underdevelopment)

To begin with, the immaturity of the hip joints in the child, this slowing of the development of the joints, while dysplasia, this is the wrong formation of the joints.

These two concepts are often confused. At the same time they constantly echo and until recently both conditions were called dysplasia.

Now concepts and terms are delineated, this distinction was necessary not only from the point of view of diagnostic definition of the problem, but also to choose more precise and correct treatment.

Types of dysplasia and immaturity

Dysplasia can be divided conditionally into several types, this is primarily always physiological or pathological appearance, immaturity of the hip joints by gradation occurs before the dislocation or subluxation.

It can be noted that as such is the immaturity of the joints, this is the least dangerous degree of development of dysplasia in newborns.

Nevertheless, if the disease is left without attention and does not begin timely treatment, complications begin to develop with time.

The child continues to grow and the violation in the joint remains unchanged, without treatment itself, the disease, that is, the immaturity of the joints, does not go away.

After a while, the untreated problem can develop into arthrosis of the hip joint, as a result of gait disturbance and constant pain sensations.

From the point of view of treatment, the most dangerous precedent is a subluxation or pre-exertion of the joint. This is a hypoplasia, in which there is no displacement of the head of the femur.

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As for the most difficult form of dysplasia, here doctors unequivocally call a dislocation of the femoral head.

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Ignoring this type leads to the fact that the skeleton develops incorrectly in newborns, one leg remains shorter than the other, the gait is broken.

The problem is that such violations remain irreversible, that is, if children do not solve the problem, then in adolescence or in adulthood it will be impossible to correct the violation of the gait.

Because of this development in the newborn begins to disrupt the motor development, subsequently arise frequent pain in the joints, the discrepancy in the length of the legs can eventually reach 10-15 centimeters.

Signs and Symptoms

The problem of diagnosis is that a newborn can not ask about his subjective feelings.

Therefore, it is so important to detect the disease in time for a number of certain signs, which parents should first of all know about.

• According to the norms accepted in medicine, the legs of the newborn should be diverted in different directions by 150-170 degrees, of course, asymmetry of the legs should be observed, if the angle of the leg is less than the standard for the child, it is necessary to refer to orthopedist.
• If the parents notice that the child has different lengths of legs, it is worth immediately contacting the orthopedist to determine the cause and purpose of the treatment.
• Special attention is required by the gluteal and inguinal folds of the newborn. They must necessarily be symmetrical, any asymmetry is an occasion to call a doctor.
• Another sign of the development of immaturity of the hip joint in a child can be a click with the motion of the foot. This is a characteristic sound that is difficult to miss or ignore.

How to recognize the disease

In the hospital, the subluxation and dislocation of the hip joint in a newborn is determined almost immediately.

While the immaturity of the joints can be detected one month after birth, this problem is not so pronounced, and it is quite difficult to notice it immediately.

A planned examination of the newborn from the orthopedist is mandatory, and this is done at 1, 3, 6 and 12 months after birth. On each such inspection there is the possibility of setting the right diagnosis, therefore, it is not worth neglecting planned examinations.

Only on visual inspection and examination by an orthopedist should not stop.

As soon as the child turns a month, you can go to the ultrasound of the hip joints of newborns. Ultrasound is completely harmless to the child and helps with high accuracy to determine if there is a pathology of the joints.

Causes of the problem development

The immaturity of the hip joint, as a rule, is congenital, but leads to unbalanced nutrition of the woman during pregnancy and a deficiency of vitamins, a deficiency of calcium.

As a result of the lack of the necessary trace elements, the connective tissues of the fetus start to form incorrectly.

In addition, we note a number of reasons for the development of the disease:

• Hereditary, genetic predisposition,
• endocrine diseases in a woman during pregnancy,
• infectious diseases during pregnancy,
• late pregnancy,
• toxicosis,
• threat of premature termination of pregnancy,
• protracted or vice versa, too fast deliveries,
• malposition.

Despite the fact that orthopedic dysplasia can be detected already in the first months after the birth of a child, it is rather difficult to determine it, since it practically does not manifest itself.

The main signs can be observed after 3 months or even after six months of life.

What's interesting, there may be underdevelopment of the hip joints after too tight swaddling of the child, and the consequences of this approach to swaddling can not be manifested immediately, but in decades in the form of the development of arthrosis already in an adult rights.

The most difficult variant of detecting dysplasia is the moment when parents notice that the child limps while walking.

This means that the physiological problem is already fixed, one leg is shorter than the other, and the situation can be remedied only by surgical intervention.

What is used in treatment

If the immaturity of the hip joint was detected at the time, up to six months of the child's life, and a timely treatment, then in 6 months all the functions of the joint should completely come to normal, even if the deviations were sufficient serious.

The following approaches are based on conservative treatment:

• In early terms, the disorder can be treated using special tires and struts. The bottom line is that they spread the legs of the child in different directions. Used to stimulate the correct development and growth of joints in a newborn.
• A course of special vitamin therapy and professional massage is prescribed.
• A course of magnetotherapy and electrophoresis using phosphorus and calcium for treatment is prescribed. The course helps to improve blood circulation and saturate the child with the necessary hip joints.
• If there is a possibility, you need to turn to the osteopath. Correct, gentle manual influences help to restore the balance of bone structure.
• As a variant of preventive measures for immaturity of the hip joints, it is recommended to use a wide swaddling of the child.

A source: http://sustav.info/bolezni/drugie/nezrelost-tazobedrennogo-sustava-u-novorozhdennyx.html

Why there is a hypoplasia of the hip joint in newborns

Orthopedic examination is an important factor in the timely detection of joint pathology.

The article will tell you about the congenital malformation of the musculoskeletal system, namely, about hip dysplasia - symptoms of the given disease, risk factors, probable causes of occurrence, and also methods of treatment and indications for surgical interference.

If a diagnosis of underdevelopment of the hip joint is established in newborns, treatment is mandatory, but depending on the age of detection of this pathology, severity of the condition - there are different correction methods, most of which are aimed at non-surgical restoration of the usefulness of this articulation.

What is dysplasia

Hip dysplasia or undeveloped joints in newborns is the most common congenital orthopedic pathology this age and implies the presence of disrupted growth and development of all bones involved in the formation of this articulation.

The term is collective, so first of all we will understand what states are included in this concept:

• acetabular dysplasia without subluxation;
• hip joint implantation;
• full dislocation of the hip joint in newborns;
• teratological forms of hip joint pathology.

Etiology or what and who is to blame

Healthy hip joints in a newborn is characterized by the full development of two basic structures - the cartilaginous base of the acetabulum (Eng.

, acetabulum) and the femoral head located in it is centered.

Changing any of these elements in the process of formation or growth causes dysplasia.

To date, the leading theory explaining this defect is the violation of the primary bookmark of the fetus and the delay in the growth of the normally-laid joint.

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Do not exclude the effect on the fetus of exogenous and endogenous substances, which confirms increased frequency of occurrence of this disturbance in geographic areas with adverse ecological situation.

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Informing and educating parents is an important step in preventing TTP.

Factors affecting the violation of normal development of this joint:

1. Genetic factors.This theory is not confirmed definitively, however, an increase in the incidence of hip dysplasia in the presence of two hereditary features takes place. The first such change is the genetically determined generalized weakness of the joints. The second - a flat acetabulum. The question of the one-sidedness of the process remains open with one of the above-mentioned hereditary factors.
2. Hormonal causes. It is believed that the increase in estrogen, progesterone and relaxin in the mother in recent weeks of gestation stimulates the weakness of the hip joint structure. In support of this theory is the low incidence of hip dysplasia (DTS) in preterm infants who did not reach the peak of the increase in the above-mentioned maternal hormones.
3. Intrauterine Disposition. The breech presentation of the fetus has a beneficial effect on the development of the TPA. Statistically, the most susceptible to this type of pathological presentation are children from the first pregnancy. An additional factor affecting the misposition of the femoral head with respect to the acetabulum is oligohydramnion - a small amount of amniotic fluid.
4. Factors affecting postnatally. The most important reason, most often a culprit in the fact that the hip joints in new-born countries of the post-Soviet space are underdeveloped is the tight swaddling of children.
   The second factor that plays an important role in the formation of the TPA is the wearing of the child in the position of full extension of the lower extremities in the knee and hip joints with closely located legs.

Statistically, girls are more likely to suffer from this disease, bypassing boys about 7 times. All of the above risk factors require additional attention from orthopedists.

Clinical manifestations and management of a child

Dysplasia or underdeveloped hip joints in newborns in this period of life can be diagnosed only when the child is examined by an orthopedic surgeon.

Ideally, this should be done immediately after birth, but this practice is difficult due to various features of the neonatal period and the organization of health care.

Early manifestations

A number of physical tests are screening methods of research that allow isolating children with pathology in the joint:

1. Test Ortholani. This examination is performed by an orthopedist who holds the child's thighs with his thumbs, placing the rest of the fingers of the hand in the area of ​​large trochanteres of the femur. The lower limbs bend at 90 ° in the hip joint, after which they are slowly withdrawn without the use of physical force.

A healthy hip joint in newborns under the Ortholani test is taken smoothly to almost 90 ° without pathological sounds.

With TPA, abduction of the thigh will be accompanied by some difficulty in the movement of the hip to the lateral side, but when applying a minor force there is a soft click, after which the hip is removed completely. In this case, a click, if not heard, is felt by the doctor's fingers located in the area of ​​the large spit of the affected limb.

1. The Barlow test. It is done in a similar way, as you can see in the video in this article. The thumb of the examiner's hand is placed in the groin and, thus, grasping the thigh, attempts are made to insert and remove the head of the femur from the acetabulum.

In the event that during this test the "slipping" of the head is felt - the joint is considered unstable.

Physical methods of examination in children with DTS.

In the event that, after the tests described above, suspicion of underdeveloped hip joints in a newborn - the next step is ultrasound diagnosis (applies to children under 3 years old months). With its help, you can visualize the shape of the acetabulum, and also in relation to it the position of the head of the femur.

Late manifestations

If for any reason in the first year the dysplasia was not diagnosed in a child, it will necessarily manifest itself at an older age. However, at the same time, unfortunately, there are already clinical signs that will prompt the mother to turn to a specialist.

Uneven skin folds on the thigh.

• asymmetry of the gluteus folds on two legs;
• presence of additional skin folds on the medial surface of the thigh of the affected limb;
• "Click" in the joint;
• The difficulty in dressing diapers due to insufficient abduction in the hip joint;
• a sign of Galeazzi - a visual shortening of the lower limb from the DTS;
• light external rotation of the lower limb with DTS.

The photo shows Galeazzi's sign for dysplasia.

Trendelenburg's walk or "duck walk" is an indicator of a neglected case of dysplasia. To diagnose the disease in children older than 3 months (after the appearance of nuclei of ossification of the epiphyses of the femur), radiography is used.

Signs of dysplasia on the roentgenogram:

• absence or hypoplasia of nuclei of ossification of the head of the femur in a child older than 3 months;
• slanting of the roof of the acetabulum (requires the calculation of the alpha angle);
• centering of the femoral head without a lateral position.

Radiography of the pelvis and joints of a child with dysplasia.

Treatment of hip dysplasia

To date, fortunately, cases of late detection of this pathology are rare enough. The basis of therapy is conservative treatment with the help of special devices designed to form the acetabulum and the position of the femoral head in it.

For this purpose, the child's legs are placed in a constant position of the lead. Tactics vary depending on the age of the child.

The first 3-6 months of life

With free access to the ultrasound machine and confirmed instability in the hip joint, the child is placed on the lower extremities in the position of retraction and flexion in the hip joints. The dynamics of recovery are carried out with the help of SPL in the established timeframe to determine the subsequent tactics of conducting the child from the TPA.

In the absence of access to an ultrasound device in children with suspected dysplasia, an abduction pad is used during the first 6 months of life. If repeated examinations have revealed the stability of the joint - the pillow is removed, but the child is under the supervision of the pediatric orthopedist for some time.

In case of instability after 6 months of using the pillow, such a child resorts to using a tire up to the appearance of signs of normal development of the roof of the acetabulum and the absence of symptoms of DTS (usually within 3-6 months).

Pillow used to correct dysplasia.

In case if at the first examination the orthopedist has a dislocation of the hip joint, it is gently adjusted and the tire is applied to correct it.

It is never possible to resort to an independent application of a tire in a child with a TTP without the appropriate skills that an orthopedist possesses. It is important to follow the basic three rules that dictate the instruction when using the bus.

• Correct joint correction before tire application;
• avoidance of extreme positions;
• preservation of the child's ability to move his legs.

In case of inadequate correction of the TCS before the tire is installed, a trauma of the growth zone located on the posterior wall of the acetabulum and, respectively, a delay in the growth of the lower limb is possible.

Pavlik's stirrup is one of the types of tires used today.

Age from 6 to 18 months

If it is not possible to reduce dysplasia by conservative methods or delayed treatment to the orthopedist at a later age of the child, one resorts to surgical intervention. In such cases, closed reduction is used under general anesthesia and under the control of the arthrogram. Applied only in children older than 3 months.

After the performed operation, an additional tire is applied to stabilize the joint.

Permanent dislocation between the ages of 18 months and 4 years

In more adult children, closed reduction of the hip joint is rarely successful, which is why most of cases immediately resort to open surgery, which in complex cases of dysplasia is aimed at the plastic acetabular cavities.

After the operation, gypsum is applied for up to 3 months, after which the gypsum is removed to restore the fullness of movements in the joint.

Dislocation in children older than 4 years

The older the child, the harder it is to reduce and stabilize the joint in this position, and the higher the risk of complications. Avascular necrosis as an adverse consequence of the performed operative intervention in children older than 4-6 years reaches 25% among those who underwent surgery.

Each case at this age is treated strictly individually, since the presence or absence of treatment can lead to a number of complications up to the disability of the patient.

A source: https://vash-ortoped.ru/bolezni-sustavov/displazii/nedorazvitie-tazobedrennogo-sustava-u-novorozhdennyh-604

Immaturity of the hip joint in newborn infants

The immaturity of the joint is its slow development, whereas dysplasia is the wrong joint formation.

Previously, both these conditions were called dysplasia, whereas now these concepts are increasingly demarcating, which in itself is already good, since the management of such children is changing towards more sparing methods.

However, if you start the disease, then you can get all the "delights" of dysplasia, if there was an error in the diagnosis, because the line between the diseases is very thin.

Today, dysplasia of the hip joints is quite common, therefore, not only the parents of small children, but also future mothers and fathers should be informed.

Varieties of dysplasia

Dysplasia specialists are divided into several types: from physiological or pathological immaturity of the hip joints to dislocation or subluxation.

The immaturity of the joints is the least dangerous degree of dysplasia.

However, if the disease is left undetected and run, then the ossification will follow and the articular cartilage will not turn into a bone at the right time.

Over time, the newborn grows, and the violation in his joint remains, because without treatment it does not disappear by itself. In the future, this threatens the occurrence of arthrosis of the hip joint, and, therefore, a violation of the gait, and a feeling of pain in the joint.

The most dangerous types of dysplasia of the hip joint include subluxation or pre-exertion of the joint, that is, its underdevelopment without the displacement of the head of the femur.

Also later, the development of a false joint is possible. In other words, the joint can develop in the direction of the dislocated femoral head. Subsequently, the child may be impaired motor development and arise frequent pain in the joint area, and shortening of the leg, can reach 5-10 centimeters.

The main signs of the disease

Dysplasia should be detected on time and treated by a specialist. Young mothers need to know about a number of signs that indicate the presence of dysplasia in a child:

• The legs of a newborn should, according to the norm, be diverted to the sides by 150-170 degrees, they must be symmetrical. If the angle of the leg is smaller, the orthopedist should be consulted to confirm or deny the diagnosis.
• If parents observe a different length of legs for a child, then this is also an occasion for examination by a doctor.
• Should be pricked up and asymmetric gluteal or inguinal folds.
• Another sign of immaturity of the hip joint is a "click" with a certain movement of the baby's legs.

How to timely recognize dysplasia and immaturity of the joint?

Subluxation and dislocation are detected in the maternity hospital often at the time of the birth of the child at once, whereas the immaturity of the joint, in view of the fact that it is less pronounced, is determined after a couple of weeks after birth.

With timely treatment in both cases, a full correction of joint functions usually occurs.

At later terms of diagnosis of the disease (six months or more), curing a child becomes much more difficult.

As early as possible, revealing the immaturity of the hip joint in your newborn increases the chances of successfully combating this ailment.

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A routine examination should be performed by an orthopedist at one, three, six and twelve months. At any of these stages, it is possible to identify the diagnosis, so they should not be neglected. Dysplasia can be bilateral, in this case it becomes even more difficult to recognize it.

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Just look at the orthopedist is not worth it, because it's difficult to feel the hip joint.

Therefore, we advise you to boldly go to the ultrasound of the hip joint, when the newborn will be one month old.

This method is completely harmless, and besides it will determine with accuracy whether there is a pathology in the child. Also, parents themselves should regularly inspect their baby.

Causes

Dysplasia is a congenital ailment, which is a consequence of:

• unbalanced nutrition of a pregnant woman, a deficiency of vitamins, calcium, which contribute to the correct formation of connective tissue;
• hereditary predisposition;
• infectious and endocrine diseases of a woman during pregnancy;
• late pregnancy;
• Toxicosis;
• threats of abortion;
• prolonged or rapid delivery;
• pelvic fruit suggestion.

As a rule, the orthopedist discovers dysplasia already in the first month of life of the baby. Therefore, timely treatment gives a positive result. However, the difficulty is that dysplasia does not appear at first.

The signs begin to be observed only under certain circumstances, for example, at 3 or 6 months. Manifest dysplasia can due to tight swaddling or not performing gymnastics for newborns.

The most unpleasant manifestation of dysplasia is the period when the child begins to take the first steps. Parents observe abnormalities in the gait and discover the child's disease. In this case, specialists will advise surgical intervention.

Methods of treatment

If by the month of his life the child has been found to have immaturity of the hip joint or dysplasia and on time treatment, then by the half-year all joint functions should be restored, even in the case of a serious deviation from norms. Dysplasia, revealed in the early stages, is treated with special tires and struts, which spread the legs in different directions. This method is used to stimulate the proper development of the joint. Orthopedist can also prescribe vitamin therapy and professional massage. It is also important to use magnetotherapy and electrophoresis with calcium and phosphorus. These procedures help improve blood circulation in the hip joints.

It is good to find a good specialist - an osteopath who can softly manipulate the muscles to restore the balance of the bone structure. The main thing is that the specialist should be really experienced, and there are so few of them in Russia.

In order to prevent dysplasia or immaturity of the hip joints, your baby is advised to apply a wide swaddle. In general, the posture of the "frog" is very useful and convenient for the newborn, in it it should be for several hours a day.

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Mom should carry out with the newborn exercises that the orthopedist will recommend to you. This gymnastics is not difficult and does not require special skills. However, it is still better if the specialist shows you how to do it. From a tight swaddling it is better to refuse.

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Wide swaddling of the newborn

Many future parents heard the phrase "wide swaddling but not everyone knows what it is. Widespread swaddling is important for the treatment and prevention of immaturity of the hip joint, but it is performed as follows:

• fold the dense flannel diaper in a triangle and lay it downright;
• put a diaper on the baby and put it on the diaper;
• bend his legs about 80 degrees;
• Both ends of the diaper wrap the legs in turn, and fix the lower corner on the tummy;
• so that the diaper can hold better, you can over-wrap the baby with another diaper.

If dysplasia is already started, functional gypsum dressings are applied to the child's treatment, which are applied to the legs in a certain position. This method allows you to correctly form the bone.

The penultimate method of treating dysplasia is stretching on the bed using orthopedic frames under stationary conditions.

Perhaps, to some, this method will seem conservative and, nevertheless, it is very effective.

After completion of treatment, the child should still be observed at the orthopedist. Up to five years the child should be shown to a specialist at least twice a year. Then you can visit the doctor once a year. When a person grows up, he should still visit an orthopedist.

A source: http://MoiSustavy.ru/vyvih/zamedlennoe-razvitie-sustava.html