Consequences of hip dysplasia in children

Consequences of hip dysplasia in children

Many fathers and mothers of children of the first year of life hear doctors diagnose "hip dysplasia" or "congenital dislocation of the hip which are in fact a single diagnosis.

Pathology is congenital, meaning that in newborns, the hip joint is undeformed or formed incorrectly.

If you do not notice or do not treat the disease in time, the sad consequences of dysplasia will remind you of your whole life.

Causes of the disease

The causes of the disease are varied, but when answering the question, where do dysplasias come from, doctors do not come to a common opinion.

Possible reasons for the appearance of the disease include:

• heredity (transmitted through the female line);
• pelvic presentation of the fetus (the baby is born not a head forward, but vice versa);
• water scarcity;
• a large fruit (the baby has little room for full movement, the volume of motor activity of the hip joint decreases, which prevents it from developing fully);
• malnutrition of the mother during the bearing of the child;
• violation of the hormonal background in pregnant women;
• gynecological diseases of the mother, uterine fibroids or adhesions, contributing to the difficult movement of the baby in the womb;
• bad ecology.

According to statistics, hip dysplasia occurs in newborn girls up to 7 times more often than in boys. Unfortunately, the disease is observed in a large number of infants - from 5 to 20%.

Consequences of dysplasia in childhood

The lack of a proper approach to the treatment of children provokes the formation of complications.

Children with dysplasia of the hip joint begin to move independently after their peers, their gait is unstable, which becomes noticeable by the age of 1.5 years.

In patients with dysplasia, children are observed:

1. Clubfoot.
2. Flat feet.
3. Lameness. In this case, the baby limps on the leg from the patient side, the body is tilted to the side, as a result of scoliosis develops - the curvature of the spine.
4. Passing from one leg to the other (with bilateral dysplasia).

The posture deteriorates, there is a lumbar lordosis (the spine bends forward) or thoracic kyphosis (the backbone curves backwards).

Perhaps the development of osteochondrosis (damage to the tissues of the spine, intervertebral discs, the connected apparatus of the spine), as an aggravating disease.

There are cases when dysplasia of the hip joint from one-sided to overgrowth to bilateral. It is possible to earn disability from infancy.

Symptoms of dysplasia of legs in childhood

The baby grows, becomes older, pathologies that are not eliminated in a timely manner, are manifested - the body does not withstand prolonged increased loads.

It is observed in 2-3% of cases, unfortunately, medical science is not yet able to influence this fact.

Appropriate intervention will save in the future from expensive, hazardous to health treatments. Trying to cure dysplasia of the hip joint by folk methods is simply useless!

After getting rid of dysplasia in childhood, the baby is healthy, but doctors do not recommend professional sports.

The exception is skiing and water sports, where the load is distributed to the lower limbs, during training, muscles are strengthened and stabilized.

It is extremely important to monitor the weight, maintain normal, excessive weight is harmful to the joints.

What is dangerous is untreated in childhood dysplasia

Having started or not cured the disease in infancy, parents doom the child to health problems during the adult years of life.

Often already adults, patients with dysplasia, unusually plastic and flexible (become elastic, joints - mobile). The adult person is not able to guess about the diagnosis, exhibited accidentally during the passage of ultrasound. As a result of the disease in humans:

• poor posture develops;
• there is stiffness of movements, a crunch in a joint at movement;
• the gait is disturbed; gait of a child
• develop violations in the lumbar spine;
• the probability of jamming the nerve endings is high, as a consequence - numbness and tingling in the leg, swelling of the foot, shin and thigh;
• in young years there is an arthrosis - a disease, usually characteristic of old age.

With dysplasia, the legs are not ready for prolonged exertion. The general "looseness" of the locomotor system develops.

If the children do not correct the congenital dislocation in time, the joint will gradually adapt to the abnormal motor function, it will acquire other outlines and will not become full. He will not adapt to ensuring the support of the limb, to adequate retraction.

The adult person is no longer helped by orthopedic devices, the formation of the body has long been completed. The medicine will eliminate dysplasia of the hip joint even in the elderly person, exclusively surgically, or with the help of prosthetics.

Aggravating diseases

Neoarthrosis is considered an aggravating disease - a new joint is formed in the pelvic bone tissue. The body will adapt if the dislocation of the femur is not eliminated.

The pelvic bones and thigh bone will change during growth: the acetabulum becomes gradually overgrown, a new hollow will form. Such an adaptation of the body entails a shortening of the thigh and difficulties with the functions of the muscles located nearby.

Neoarthritis is not an alternative to a full joint, but it can perform the functions of a healthy component of the body for decades.

The onset of the disease is acute, the disease progresses rapidly.

The patient is disturbed by strong constant pains, osteochondrosis of the spine develops, the motor activity, the gait changes, which grows into ankylosis - pathology, when the joint is set bending.

Dysplastic coxarthrosis causes disability, it is impossible to move without a cane. There are cases when the aching leg becomes shorter, an operation is possible to replace the joint, otherwise the person loses his ability to work.

How to recognize dysplasia

Parents of newborns should immediately show the child to an orthopedic doctor if:

1. a toddler of different length;
2. asymmetrical creases on the buttocks;
3. On the thigh there is an extra fold;
4. asymmetrically removed legs;
5. the toes of the toddler do not touch the surface of the table when the legs are withdrawn; they can not be completely removed;
6. the hip joint of the child walks easily, with a characteristic click (it is audible, as the head of a femur from an acetabulum drops out).

When the baby has already started walking alone, or has turned more than a year old, parents should be alerted:

• "Duck's gait the carapace swings in different directions when walking;
• the habit of a child to walk on socks.

The earlier the disease is identified, the better for health. Medical practice shows that 90% of newborns with initial type dysplasia have a half year of illness, provided they undergo treatment and follow medical prescriptions.

If the disease is diagnosed after six months, treatment in children is a long period, the result will be worse (surgical intervention is not ruled out).

If the diagnosis of "dysplasia" is made to a child who has already learned to walk, unfortunately, there is no need to fully recover. Treatment of dysplasia diagnosed after 12 years, can last more than a decade.

The consequences are unpredictable, so the pathology of newborns should be treated on time, not to miss visits to the clinic.

Diagnosis, treatment and prevention

Newborns are examined at the hospital. Older children are diagnosed with hip dysplasia with ultrasound. Apparatus ultrasound available, the procedure is not harmful to health, it is permissible to spend children, starting with 4 months of life.

For children over 6 months of age, a mandatory x-ray is prescribed.

There are cases of dysplasia in newborns that are not accompanied by well-known symptoms (18%), according to this reason to establish the diagnosis is only possible with the help of ultrasound or radiographic research.

The speed of recovery in children is directly related to the time of diagnosis. The younger the baby, the easier it is to heal. Correctly selected treatment will help the hip to mature in the child's body.

Methods for eliminating the disorder doctors choose, based on the degree of disease.

If there is a dislocation of the joint, an osteopath will perform a soft correction, which will require several sessions to bring it to normal. Effective for the treatment of massage, physiotherapy and physiotherapy:

1. ozokerite;
2. amplipulse;
3. electrophoresis;
4. mud treatment.

Doctors recommend to adhere to preventive measures, here carry:

• wide swaddling;
• preventive massage once a quarter;
• the use of special devices for carrying newborns, allowing you to keep your legs widely apart (slings, ergo backpacks, car seats).

A source: http://OtNogi.ru/bolezn/drugie/posledstviya-displazii-tazobedrennyx-sustavov-u-detej.html

Hip dysplasia in newborns: why develops and how to fight

Quite often in the maternity hospital, at the first planned admission to the pediatrician or when visiting a pediatric orthopedist, parents hear an alarming diagnosis: "hip dysplasia in newborns."

But this is not a reason for panic - on the contrary, it is necessary to know that only the timely and correct treatment of the baby and compliance with all the recommendations of a specialist will help to avoid unpleasant consequences in future.

What is hip dysplasia?

To date, dysplasia of the hip joint is considered the most common pathology of the musculoskeletal system in newborns and infants.

"Dysplasia" in translation means "improper growth in this case one or both of the hip joints.

The development of the disease is associated with a violation of the formation in the intrauterine period of the basic structures of the joint:

1. ligamentous apparatus;
2. bone structures and cartilage;
3. muscles;
4. change in the innervation of the joint.

Most often, hip dysplasia in newborns and treatment of this pathology is associated with a change in the location of the head of the femur with respect to the bone pelvic ring. Therefore, in medicine, this disease is called a congenital dislocation of the hip.

Treatment must begin with the diagnosis of pathology, the sooner the better, and before the baby starts walking - from this moment there are irreversible complications. They are associated with an increasing strain on the joint and the exit of the head of the bone completely out of the acetabulum with a shift upwards or to the side.

At the child changes are formed at walking: "duck" gait, significant shortenings of a limb, compensatory curvatures of a backbone. To correct these violations it is possible only through surgical intervention. At the expressed changes in a joint the kid for all life can remain the invalid.

Causes of ailment

There are several theories that answer the question - why there is dysplasia of the hip joints in the newborn - what are the reasons for its formation?

The main factors that negatively affect embryogenesis and the formation of the musculoskeletal system of the fetus are the following.

Family predisposition(in 80% of cases the development of dysplasia was observed in the immediate relatives of the baby, most often the disease is transmitted through the female line) - hereditary theory.

Hormonal disorders in recent months of gestation(hormonal theory) - a high level of progesterone and / or other hormones in the blood of a pregnant woman causes persistent decrease in muscle tone and ligament of large joints, leading to instability in the hip joints.

These states can arise in connection with:

• with hormonal imbalance on a background of stress, fatigue in the last weeks before childbirth;
• endocrine diseases of the pregnant woman (pathology of the thyroid gland, adrenal glands);
• taking hormonal drugs to treat the threat of abortion, containing progestins - hormones maturation, inhibiting the growth of many structures, including bones.

Violation of the laying of organsin connection with the lack of trace elements (phosphorus, iron and calcium) and vitamins in the first months of pregnancy - the largest percentage of babies with dysplasia are observed during conception in the winter months.

Exposure to toxic factors:

1. adverse ecology;
2. occupational hazards;
3. taking various medications;
4. infectious diseases of the expectant mother;
5. intrauterine infections;
6. toxicoses;
7. kidney and liver diseases in pregnant women.

The impact of several negative factors.

Additional predisposing and provoking causes of pathology are:

Forms of pathology

In pediatric orthopedics, several forms of the disease are distinguished. Depending on this, there are signs of dysplasia of the hip joints in infants, in this regard, and choose methods of treatment of pathology.

The most commonly diagnosed acetabular form of the disease, which occurs as a result of violations of the position of the head of the joint in the acetabulum of varying degrees:

• mild dysplasia of hip joints in newborns - pre-exertion;
• subluxation - violations of the average degree;
• congenital dislocation of the joint.

Congenital anomalies are less common:

1. rotational form of dysplasia associated with changes in the configuration of the bones and structures that form the joint;
2. wrong development of the hips of the proximal part.

Determine the form and extent of dysplasia can only be an orthopedic doctor after examining the child and carrying out a full range of different diagnostic methods.

Symptoms of ailment

Symptoms of hip dysplasia in newborns can occur immediately after birth or as the baby grows.

Diagnose pathology in the hospital, with routine examinations of a pediatrician or a narrow specialist - a pediatric surgeon or orthopedist

Parents are often concerned with the question: - How to determine dysplasia of hip joints in newborns independently?

Symptoms of mild degree of hip dysplasia in infants and subluxation are most often seen only on 2-3 weeks after discharge of the baby from the hospital. They can be noticed by parents when they spread the baby on the stomach or do gymnastics to a crumb.

Symptoms of hip dysplasia in infants:

• asymmetry of the folds on the legs, if you put the baby on the stomach - under the buttocks and on the hips;
• different length of lower limbs - shortening of the leg on the side of the change in the joint;
• limitation of mobility in hip reduction - this symptom is more often observed with unilateral lesion - dysplasia of the left hip joint in newborns or subluxation on the right;
• the symptom of a "click" is the appearance of a characteristic click when the baby's hips are guided at a 90-degree angle and pressing on a large spit in connection with the insertion of the head into the joint.

If long-term treatment is not available, the disease can manifest itself with more serious disorders and manifestations of hip dysplasia in the infant:

1. atrophy (thinning) of the muscles on the side of the lesion;
2. persistent disturbances in walking: frequent falls, swaying from side to side, "duck" gait, pain when walking, contracture (persistent restriction of movement in the hip joints).

The appearance of these symptoms often indicates a complete exit of the head of the bone from the joint and its displacement upwards or to the side, which causes dangerous consequences of hip dysplasia in the infants.

Diagnosis of pathology

Detection of pathology and refinement of the diagnosis of hip dysplasia is carried out through a comprehensive diagnosis:

• characteristic manifestations of hip dysplasia in a newborn - symptoms of the disease;
• anamnesis of pregnancy and childbirth - presence of risk factors for the development of pathology;
• instrumental methods of examination;
• differential diagnostics

Instrumental diagnostics

The instrumental methods of diagnosing hip dysplasia include:

1. X-ray examination;
2. arthrography or arthroscopy;
3. Ultrasound - diagnosis;
4. CT or MRI of the joints.

Based on the results of instrumental examinations, the specialist specifies the form and extent of pathology and determines how to treat hip dysplasia in infants.

Differential diagnostics

This type of diagnosis is carried out by a pediatric orthopedist to completely eliminate diseases that have similar symptoms:

• pathological dislocations or fractures;
• complications of rickets;
• congenital disorders of metabolism and osteodysplasia;
• pathology of the nervous system, complicated by paralytic dislocations.

Treatment and therapy

There are several ways to treat hip dysplasia:

1. Conservative therapy.
2. Surgical correction, in severe cases, multiple surgical interventions are required - the head is inserted into the joint gradually and is fixed by various methods.

With mild degree of dysplasia and subluxation, a combination of various methods of conservative treatment under the supervision of the attending physician is used:

• Wide swaddling for a month or two - this contributes to the proper formation of the joint and / or self-management of subluxation.
• Wearing various orthopedic devices that hold the baby's legs in a dilute and bent state (stirrups, pillows, tires, functional plaster bandages).

And also physiotherapy techniques that reduce inflammation, activate trophic processes in tissues and reduce the risk of contracture formation, and also reduce pain:

1. electrophoresis;
2. magnetic-laser therapy;
3. ultrasound therapy;
4. amplipulse;
5. massage with hip dysplasia in infants;
6. mud treatment;
7. Gymnastics for hip dysplasia in newborns.

Timely conservative treatment of this disease in 90% of cases gives a positive result and complete cure of the baby without the formation of dangerous for health complications.

Incorrect therapy or lack of it for hip dysplasia in newborns causes serious health consequences and the need for prompt intervention.

But even surgical treatment of hip dysplasia in a baby can not always be fully correct orthopedic disorders caused by persistent bias and full exit of the femoral head from the joint.

Quite often the child observes:

• marked curvature of the spine;
• limb shortening;
• persistent disturbances in walking;
• severe pain syndrome, due to the development of arthropathy or arthrosis of the hip joint.

Massage for dysplasia of hip joints in newborns is carried out by courses that are prescribed by the orthopedist.

Parents should know that even after the end of active treatment of this pathology, it is necessary to continue to perform Exercise for hip dysplasia in newborns, do not use a walker and avoid early training walking.

Prevention of hip dysplasia in newborns is the elimination of all predisposing and provoking factors and causes of pathology during pregnancy and after childbirth.

It is important to know that if you do not detect the disease in time or if you are not serious about treating it, the child can form a shortening of the limb, gait disturbance, persistent deformation of the spine and constant pain in the back and joints. Therefore, parents should know the signs and methods of treating this complex pathology.

A source: https://moirody.ru/newborn/tazobedrennaya-displaziya-u-novorozhdennyx.html

Dysplasia of hip joints in children: causes, symptoms, treatment

The development of a child before the year is rapid: every day brings something new. The kid sits down, begins to creep, rises on the legs... finally, takes the first step. Delight and tenderness of parents have no limits.

However, sometimes shortly after this joyous event, it becomes clear that the gait is not all right: the child strangely puts the legs, or limps, or overtakes when walking.

What is it? And this is most likely the manifestations of hip dysplasia.

Hip dysplasia (DTS), or congenital subluxation of the hip joint is called underdevelopment (or abnormal development) the joint itself or its components: the acetabulum of the pelvic bone, cartilage, ligaments and muscles that hold the femur in the correct position.

Manifestations of such pathology are sometimes difficult to identify to parents at an early age of the child.

The initial diagnosis of this congenital pathology is carried out immediately after the birth of the infant, which allows to prevent its serious consequences, developing with late detection.

In the absence of contact between the femoral and pelvic bones, the femoral can move freely outside the joint. This condition is called a joint dislocation, or dislocation. There are 2 subspecies of dislocation: teratological and typical.

Teratological develops in utero due to genetic diseases or anomaly of the development of muscle tissue. It is rare.

A typical dislocation is characterized by the existing contact between the two bones, but it is incomplete, unstable.

This pathology of development is most common and can occur both in utero and after birth in healthy newborns.

Subluxation is less severe: contact between the bones is normal, but the joint is unstable and the femur is easily separated from the acetabulum.

Causes of development

The true cause of pathological development or underdevelopment of the joint is not fully known.

Predisposing factors are:

1. genetic predisposition (more often on a female line);
2. female sex of the baby (80% of all cases of dysplasia);
3. hormonal background: an excess of progesterone in women before birth can contribute to the development of the ligamentous-muscular system;
4. the wrong position of the fetus in the uterine cavity, which limits the normal mobility of the child;
5. large fetal dimensions that limit its movement and impede the development of the joint;
6. harmful factors, especially in the early stages of pregnancy (ecology, toxicosis, maternal diseases, beriberi, etc.);
7. prematurity: the fetal tissues do not have time to ripen.

Symptoms of joint pathology

The pathology of the development of joints in the normal position of the legs does not cause any unpleasant or painful sensations in the infant. Because of this, it is difficult to notice the parents of underdevelopment of joints in the early periods.

The first manifestations of pathology can appear when the child begins to walk. With the TPA on both sides, swinging on walking or the so-called "duck walk" is noted. With maldevelopment of one or both joints a child can limp, walk "on tiptoe" (not to step on the heels).

At the slightest suspicion, you should consult a doctor who can determine the diagnosis not only by examining, but also by carrying out special manipulations. With TPA, these symptoms are:

• different length of lower extremities, shortening of thigh;
• asymmetry of folds on the inner thighs (a nonspecific symptom can also be noted in healthy babies);
• pain (child reacts with crying) or restriction of movements when trying to bend the legs to the sides of the half-bent legs (normal in the infants the legs are bred to 90 °);
• the head of the femur is easily (with a click) pulled out from the acetabulum and returns to it: this indicates an increased elasticity of the joint;
• excessive mobility in the hip joints: the baby can unnaturally turn out the legs on the outside or inside.

Diagnosis of joint pathology

To confirm the diagnosis, suspected by the doctor when examining the child, apply:

1. Ultrasound (in the first half of the life of the baby);
2. X-ray examination (after 6 months, since at an earlier age the bone system is underdeveloped, consists of cartilages that are difficult to fix on the roentgenogram).

An additional examination is necessary to detect TTP, as sometimes even an experienced doctor can make a mistake.

So, according to statistics, pediatricians suspect this pathology of joints in cases of 1000, orthopedic doctors - in 1 cases, and with ultrasound revealed violations of the structure of the joints in 25 children out of 1000.

Ultrasound is the prevalent method of diagnosing hip joint pathology in the first months of a baby's life: it is more informative than a simple medical examination, painless, does not give irradiation. The study provides an opportunity to see a clear form of the cavity of the pelvic bone, which is of great importance in the development of dysplasia.

It does not make sense to have an ultrasound until 4 weeks of a newborn's life, because some changes in the hip joint structure disappear on their own, without treatment during the first month of life.

Symptoms of DTS, which can be identified using additional survey methods:

• flattening or deformation of the acetabulum of the pelvic bone;
• underdevelopment of the head of the femur or cartilage;
• excessive stretching of the capsule of the joint or ligament apparatus;
• wrong angle of the femur;
• partial (or complete) exit of the femur from the acetabulum.

Treatment of exercise therapy

Therapeutic physical training and massage are included in the treatment of dysplasia of the hip joints.

The objectives of treatment activities in DTS:

1. ensure a fixed position of the head of the femur in the acetabulum;
2. strengthening of the cartilaginous tissue and the ligamentous-muscular apparatus of the joint, in order to exclude excessive mobility of bones and ligaments.

Depending on the degree of severity and timing of diagnosis, treatment of DTS can be conservative and operative.

Conservative treatment includes such types of treatment:

• orthopedic means;
• physiotherapeutic procedures;
• physiotherapy;
• massage;
• closed direction of dislocation.

There is a wide range of orthopedic products, the main purpose of which is to keep the legs of the baby in a dilute and bent position without restricting the movements of the child (which is very important). Orthopedic tools keep the head of the femur in the correct position, which ensures the normal formation of the joint.

The most popular of these means is Pavlik's stirrups. They are usually used in children up to 6 months of age. The effectiveness of the drug is about 85%, so during their use, medical supervision is necessary.

Orthopedic means splinter fixes the legs of the baby in a dilute position with the help of metal appliances, which contributes to the proper development of the joint.

However, no convincing data on the effectiveness of such swaddling were obtained. Some doctors recommend it even now.

Physiotherapeutic methods of treatment are applied: electrophoresis with calcium chloride, ozocerite applications, mud therapy. Procedures contribute to the development of underdeveloped joints.

Therapeutic exercise is used in the form of complexes of special exercises in accordance with the stage of treatment and the age of the child. A good effect is given by swimming on the stomach. LFK helps to strengthen the muscular apparatus and restore the volume of movements.

Muscles of the thigh and gluteal region well strengthens properly performed massage.

If the use of these methods of treatment from 3 months of age and up to 2 years has not produced a result, then rigid fixation for complete immobility of the hip joint in the form of a coxitic bandage after the dislocation is closed closed way. Gypsum can be imposed depending on the complexity of the case with one of 3 options: one leg and half of the other leg, two legs or one leg.

Surgical treatment is usually used with far-reaching dysplasia and ineffectiveness of previous treatment methods.

More often it happens in those cases when the DTS is detected in a child older than a year already in the stage of a developed hip dislocation.

Although in some cases even timely detection and treatment of the disease is ineffective.

Surgical intervention is achieved in the reconstruction of the hip joint.

Sometimes only one operation is performed, and in another, more complicated case, there may be a need for multistage surgical intervention.

Such methods of surgical treatment are applied:

1. Direction of dislocation by open method and gypsum-fixation. The surgeon inserts the head of the femur into the cavity of the pelvic bone during surgery. Applicable in cases where closed-path closure was ineffective. The operation is possible when the osseous nucleus appeared, that is, the head of the femur from the cartilaginous bone has already turned into bone.
2. Tenotomy, or lengthening of the tendon surgically to ensure the correct insertion of the femoral head into the cavity. After the operation, a plaster bandage is also applied for 6 weeks. After this, they undergo an examination under anesthesia (to achieve complete relaxation), and make an X-ray of the joint. If it is unstable, re-impose a plaster bandage.

Such examination (under anesthesia) can be carried out after ineffective application of the splinter method for decision on the further tactics of treatment (for example, to conduct a closed or open through).

• Osteotomy of the pelvic or femur: an artificial fracture of the femur below its head and a turning of the femur into an optimal position; or deepen the acetabulum in the pelvic bone. Bone fragments are fixed in the correct position with the help of metalosteosynthesis (metal plates and bolts). In a year, when the bone is consolidated, an operation is carried out to remove the metal plates. Such operations reduce pain in the joint during walking and improve the function of the joint.
• Palliative operations: do not eliminate the defect in the joint, but improve the quality of life. One of the variants of such an operation is equalizing the length of the legs with the help of the Ilizarov apparatus.
• Endoprosthetics: the affected joint is replaced with an artificial prosthesis.

After the operation the child is in the hospital for several days. After surgical intervention, it is necessary to conduct rehabilitation treatment for a long time, during which massage, physiotherapy exercises, and physiotherapy are used.

Forecast

With timely detection of pathology and treatment from the first month of life of the baby, the prognosis is quite favorable: conservative treatment is effective, and in 95% of children the diagnosis is removed by the year.

In the case of ineffective treatment or late diagnosis of DTS, the consequences can be very serious, the likelihood of disability of the child is high.

Hip Dysplasia - Dr. Komarovsky's School

In the case of undiagnosed or untreated DTS, such complications can develop:

1. necrosis of the femoral head without disturbance of blood circulation (aseptic necrosis);
2. coxarthrosis: a degenerative process in the hip joint;
3. neoarthrosis, or pseudo-joint, - it is formed independently, it can not function normally: the femur completely leaves the cavity, cavity gradually overgrows, and the head of the hip forms a new cavity in the pelvic bone; gradually the head of the thigh is destroyed, this leads to lameness, pain and disability.

Resume for parents

The most reliable way to avoid serious problems and operations on the hip joint is the timely detection of congenital pathology and the early onset of painless conservative treatment. The possibility of a complete recovery of the child is directly related to the timing of anomalies in the development of joints.

A timely examination of the pediatric orthopedist and ultrasound (with the slightest suspicion of the pathology of the joints) will help confirm or exclude dysplasia.

Do not follow the parents' fear of using orthopedic drugs for treatment: firstly, they are completely painless, do not bring suffering to the baby and, secondly, the child is easily accustomed to them.

But they can help get rid of the disease by the year, and the child will walk freely.

To which doctor to apply

Symptoms of hip dysplasia can be revealed by a pediatrician, a pediatric surgeon, an orthopedist.

Conservative treatment of this disease is carried out with the help of a physiotherapist, masseur, chiropractor.

In the confirmation of the disease, the qualification of the radiotherapist, including ultrasound, plays an important role.

A source: https://myfamilydoctor.ru/displaziya-tazobedrennyx-sustavov-u-detej-prichiny-simptomy-lechenie/

Hip dysplasia in adults and children

Dysplasia from the ancient Greek language is translated as a violation of education. Simply put, it is a vice of development. Dysplasia can be noted in any stavah. But dysplasia of the hip joints is most often observed.

Causes - features of the anatomical structure

Apparently, this is due to the peculiarities of the anatomical structure and the development of the hip joint in children.

Our hip joint is formed by the articular acetabulum of the pelvis and the head of the femur, or simply - the head of the hip. The head is connected to the rest of the bone by the neck of the thigh.

To increase the area of ​​contact between the articular surfaces of the head and the acetabulum, the latter is surrounded by a cartilaginous plate - the limbus.

In this classification, hip dysplasia is located in the XVII category - congenital anomalies (malformations development), deformities and chromosomal abnormalities, in the block congenital malformations (malformations) of the musculoskeletal system.

According to this classification, this pathology has an innate character. Among the causes of hip dysplasia:

1. Genetic disorders leading to inferiority of connective tissue structures - bones, cartilage, ligaments;
2. Damage to the hip and hip joint as a result of birth injuries caused by increased tone of the uterus, pelvic presentation of the fetus;
3. Influence of external negative factors on the organism of the pregnant woman - stresses, industrial, household toxins, infections;
4. Hormonal imbalance - increased synthesis of progesterone during pregnancy, which relaxes muscles and ligaments;
5. Drinking alcohol, drugs, smoking during pregnancy.

Not the least role in the development of dysplasia of the hip joints with their inherent immaturity plays a tight swaddling, at which the hip axis is displaced, and the head of the femur goes beyond the acetabular cavities.

In some cases, hip dysplasia in adults is observed. It is believed that this pathology in the adult period predisposes to increased stress on the joint - exercise, dance, gymnastics.

Apparently, in adults this pathology also has an innate character. Simply, the anatomical changes in the joint and in the ligaments are minimally expressed, and up to a certain time they are not diagnosed.

And physical activities are not causes, but provoking factors.

Types and degrees

Depending on the nature of the anatomical disorders, the following types of hip dysplasia are distinguished:

• Acetabular. The articular cavity has been altered - it is flattened, the limbus is thinned or displaced.
• Changed the head of the thigh. When the femoral head is changed, the anatomical correspondence (congruence) of the joint hip surfaces is also violated. Along with the head, the neck of the hip often suffers, which leads to a decrease or increase in the angle between the neck and the femur.
• Rotational. It is caused by pathology of the femur and often - the knee joint, shin. In this case, the entire lower limb is rotated (rotated) inwards.

Structural changes in the hip joint are of unequal severity, in connection with which the following degrees of hip dysplasia are distinguished:

You can also read:Why does the hip joint hurt?

1. The anterior part is articular surfaces changed, but the head is located within the acetabular joint cavity.
2. Subluxation - further displacement of the head relative to the joint surface. The head partially extends beyond the articular cavity.
3. Dislocation - the head of the femur has completely gone beyond the joint cavity.

All these degrees with the appearance of the corresponding symptoms of dysplasia of the hip joints develop against the background of the so-called. immaturity of the joint. This immaturity is characterized by weakness of muscles, ligaments and the above signs of joint disorders.

Symptoms in the first-born female

Congenital dysplasia is most often noted in the female first-born.

This is due to the fact that girls react more to maternal progesterone than boys, as well as a more increased tone of the uterine musculature during the first pregnancy.

Although, in male toddlers, dysplasia is sometimes diagnosed. According to statistical data, this pathology is observed in 2-3% of newborns of both sexes.

Among the main signs of hip dysplasia:

• Different length of lower limbs. On the side of dysplasia the leg is shortened.
• Rotation of the entire lower limb inside.
• Limitation of lead. The child lies on the back, and clasps the legs, bent at the knee and hip joints. In this position, the legs are bred. With normal development of the hip joint, the leg is removed under a straight (or close to a straight) angle. With dysplasia, the angle of lead is significantly less.
• Click symptom. In some cases, with the hip in the above position, you can hear the click of the femoral head, which indicates a dislocation. When the thighs are brought together, the click is heard again - the dislocation is corrected.
• Asymmetric arrangement of skin folds. In the position on the abdomen, 3 creases are defined on the surface of the hips. On the side of the dislocation, these folds are higher than on the healthy one.

According to statistical data, all the above symptoms are more often noted on the left lower extremity.

Diagnosis of dysplasia

Diagnosis of hip dysplasia is carried out during external examination and instrumental research. Suspect pathology can be based on the characteristic symptoms mentioned above.

Roentgen confirms the diagnosis. Radiographic photographs clearly show structural disorders of the joint elements. In children up to 6 months. For diagnosis, ultrasound of the hip joint can be used.

This is the dysplasia on the radiographic image

Treatment of dysplasia

The earlier the diagnosis is made, the more effective the treatment, which should be carried out literally from the diaper. Otherwise, such consequences of hip dysplasia as lameness, persistent limitation of movements in the hip joint, atrophy of the muscles of the thigh and lower leg are possible.

In adults, these factors lead to arthrosis changes in the hip joint, to disability.

The problem is that in the anatomically altered acetabular joint cavity, over time, connective tissue, and subsequently achieve complete anatomical matching of the articular surfaces in practice is impossible.

Currently, with hip dysplasia, various types of fixation bandages

Fortunately, in most cases, in young children, congenital dislocations and subluxations of the hip are spontaneous. For this lower limb, the position of the abduction in the hip joint should be given.

To this end, use special fixing orthopedic devices - Pavlik's stirrups, Freik's pillow. These devices are used up to six months of age.

At the same time, one should abandon the tight swaddling, which provokes hip dislocation and subluxation.

In parallel with the orthopedic correction, they perform health gymnastics - flexing and unbending the legs in the knee and hip joints, leading the legs in the position on the abdomen.

However, closed direction can be carried out only in early childhood. After 5-6 years, this can not be done, and the dislocation is only corrected by the open method, during the operation.

Other types of surgical interventions to eliminate hip dysplasia suggest different types of acetabulum, limbus and articular ligament plasty.

A source: http://MoyaSpina.ru/bolezni/displaziya-tazobedrennogo-sustava-u-vzroslyh-i-detey