Ossicles of ossification of the hip joints: norm and pathology

Ossicles of hip joint ossification: norm and delay of ossification

The musculoskeletal system and the condition of the hip joints have a close relationship.

Ossification of pelvic bones occurs in stages and the completion of development falls on a 20-year period.

Bone tissue in turn is formed when the fetus is not yet born and is in the womb of the mother. It is at this point that the formation of the hip joint begins.

As a rule, this phenomenon is attributed to pathology, which can affect the development of the musculoskeletal system. If the nucleus does not develop throughout the year, the full functioning of the hip joints is in jeopardy.

Pathology of the hip joint

• Physicians diagnose the rate or delay in the development of the nucleus based on the general condition of the hip joints. In the case when newborns do not have a dislocation in the pelvic region, the slow development of the nuclei is not considered a pathology. Also do not refer to a violation if the child has a full functioning of the hip joint.
• If the newborn has disorders of the musculoskeletal system and a dislocation, while this condition is caused due to the absence of the nucleus of ossification, pathology is considered dangerous for health. This phenomenon can harm the baby and disrupt the growth, development, functioning of the inferior hip joints.
• A similar pathology of the absence of ossification nuclei is usually found in infants and children under one year of age. From that. How intrauterine development takes place, the presence of disorders of the musculoskeletal system depends. Bone tissue is laid in the fetus during 3-5 months of pregnancy.

The normal condition of ossification nuclei is responsible for the full development of the musculoskeletal system of the baby. When the baby is born, the size of these nuclei is 3-6 mm - this is the norm of development of the bones and tissues of the fetus.

Meanwhile, it is not uncommon for full-term children who developed normally in the womb to have problems with the development of the hip joint. A similar violation is detected in 10 per cent of the children born.

The hip joint is formed around the eighth month of pregnancy. However, the norm of the formation of ossification nuclei is not the same for all babies.

There are cases when the long period does not develop the nucleus, as a result of which the tissue itself slows down.

After a while, the active development of the hip begins.

Thus, by the eighth month of being in the womb, the nuclei of ossification become the right size, while they do not differ in structure from the long-formed nuclei of other children.

Reasons for ossification of the nucleus

When the fetus develops, its femoral joints increase. Similar is observed with nuclei. The delay in the development of the nucleus of ossification or ossification can be caused by some negative factors that cause the slow growth of the hip joints.

Ossification is usually found in every second child suffering from rickets. Because of the disease, children experience an acute shortage of nutrients. Tissues of muscles, ligaments, tendons and bones can not get the necessary trace elements and vitamins.

With dysplasia of the hip joint, an incorrect formation of the ossification nucleus can be observed.

Usually, this condition is revealed in children who are on artificial feeding.

The main symptoms of dysplasia in a child are:

1. Absence of symmetry of skin folds;
2. Limited movement of joints during hip abduction;
3. Symptoms of laxation or slipping;
4. External rotation of the femoral joint;
5. A shortened lower limb.

The general condition of the father and mother directly affects the presence or absence of pathologies of the hip joints. First of all, the condition of the nuclei of ossification depends on the maternal health.

So, in the presence of diabetes mellitus in one of the parents, the nuclei will have a slow development.

In this regard, the hip joints will develop slowly enough compared to their peers.

In this case, doctors take all measures to stimulate and accelerate the development of the musculoskeletal system.

Also, such measures may be required if the parents have thyroid disease. Usually the nuclei of these babies develop slowly.

As a supplement, the metabolism is disrupted in the child, which becomes the main reason for delaying the development of hip joints and delayed formation of pelvic tissues.

How intrauterine development takes place also affects the health of the newborn and the state of the musculoskeletal system.

In the case of pelvic, transverse, breech presentation of the fetus, the nucleus may develop slowly or be completely absent.

The lack of nucleus formation is most often associated with a lack of vitamin B and E in the body, as well as vital microelements such as calcium, phosphorus, iodine, iron. All this directly affects the health of the baby.

Including hormone failure, bipartite pregnancy, gynecological health problems, viruses and infections of the mother may be the cause of the undeveloped core.

Genetic predisposition to hip joint disease can also lead to the development of pathology, which in some cases is inherited.

Improper formation of the nucleus is facilitated by unfavorable ecological conditions, premature birth of the child. Meanwhile, every fifth case of disorder in the body is associated with a genetic cause.

Dangerous for the baby is the slow development of the spine and spinal cord in the mother. To the violation of the musculoskeletal system can lead to an increased tone of the uterus.

Assisting a newborn

In the first years of the baby's life the femoral joints should stabilize. The neck of the femur should gradually ossify.

Including the strengthening of the ligamentous apparatus, its head is centralized.

In order for the musculoskeletal system to function properly, the angle of inclination of the acetabulum should decrease.

Active formation of the nucleus of ossification occurs in 5-6 months and by five to six years it increases approximately tenfold.

In 15-17 years, cartilages are replaced with bone tissue. The neck of the femoral joint continues to grow until the age of 20, after which the bones form in the place of the cartilage.

If during all this time there was a wrong development, the head of the femurs can not be held in the hollow of the hip joints, in this case the doctor diagnoses dysplasia.

To avoid the development of pathology, you need to seek medical help at the first suspicious symptoms.

The pathology of the nucleus is revealed through ultrasound and sonographic examination. In addition, X-rays of damaged pelvic joints are performed.

In order for the hip joints to develop correctly, the doctor can advise using a special orthopedic device. With delayed development of the joint head, treatment and prevention of rickets are prescribed.

In this case, it is recommended to wear a special tire. As an additional measure, therapeutic massage and electrophoresis are prescribed. Improve the condition of the baby can help the bath with the addition of sea salt and paraffin application.

Preventive measures for mothers

Despite the genetic predisposition to the disease, it is possible to predict in advance the possibility of a violation in the child's body and prevent the development of pathology in the fetus.

For this, there are certain preventive measures that help to maintain the health of the baby.

Since nutrition primarily affects the condition of the child, during pregnancy, the mother must fully eat and receive all the vital microelements and vitamins.

It is on this that the full development of all the joints of the fetus growing in the womb depends.

If there is any suspicion of a lack of vitamins in the mother or child, you need to immediately notify the doctor about this, since beriberi and rickets negatively affect the musculoskeletal system.

In the period of breastfeeding, it is also important that a woman receives all the necessary substances and competently feeds. To support the motor system of the child developed fully, at 7 months in the diet of the baby should include additional food.

To develop the musculoskeletal system, you should regularly walk outdoors, do massage, gymnastics and hardening procedures.

A complex of procedures for the development of the pelvic area will help to select a pediatrician.

In autumn and winter, the child must necessarily with the goal of preventing vitamin D, on which the growth and development of bone composition depends.

A source: http://sustav.info/bolezni/drugie/yadra-okosteneniya-tazobedrennyh-sustavov.html

Features of the formation of the thigh bone of the hip joint (ossification nuclei)

Ossification of the hip joints takes place gradually and ends by 20 years.

The foci of formation appears even in the fetus, but the most active development occurs in recent months pregnancy - that's why if a child is born before the time, then the nuclei of his joints will not be are formed.

Deviation in ossification of the heads of the hip joints can also occur in full-term children, that indicates a pathology - the absence or slowing of ossification (hypoplasia or nuclear aplasia ossification).

If the time is not taken, the development of the musculoskeletal system will occur with serious disabilities.

Normally ossification nuclei appear at the age of 3-5 months

Anatomical features

The time of appearance of radiologic signs of ossification centers in children is 4 months (half a year is also considered the norm). In girls, the process can occur about one month ahead of that of boys.

By the end of preschool age (5-6 years), these areas of bone growth should increase in size by more than 10 times.

If such ossification is not present in children, this is a sign of pathology and urgent treatment is required.

Causes of abnormalities

The delay in the development of the zone of ossification can occur under the influence of several factors:

• diabetes,
• artificial feeding,
• thyrotoxicosis,
• hypothyroidism and other pathology of metabolic systems;
• rickets of the osteoarticular apparatus (about 50% of toddlers);

Quite often, hypoplasia of the femoral joints is combined with joint dysplasia (congenital hip dislocation). This pathology is more often observed in newborn females.

The anatomical feature in children with dysplasia is that they do not have a coincidence between the center of the femoral head and the center of the nucleus. Dysplasia is characterized by underdevelopment of the acetabulum and proximal femur.

This interferes with the full function of the femur.

The development of dysplasia can be expected in the following cases:

1. infectious diseases of the mother during gestation;
2. burdened heredity of children;
3. elderly parents;
4. toxicosis of the mother during the gestation;
5. fetal presentation of buttocks.

In order to make the correct diagnosis, it is necessary to conduct a detailed study

Dysplasia develops even in the fetus, and the displacement of the head (dislocation or subluxation) of the femur of the thigh occurs secondarily in the newborn with the load on the joint:

• Precipitations- characterized by the restriction of passive dilution of the legs of a newborn, bent at right angles, increased muscle tone of the lower limbs, there is no symmetry of the skin folds on the thigh and gluteal femoral folds.
• Subluxation- characterized by a symptom of Ortholani-Marx (slipping in the head of the femur at reduction with subsequent correction at the hip withdrawal), which is defined as a "click" at hand explorer. There may also be a shortening of the limb.
• Dislocation- is characterized by impaired walking: tense adductor muscles, severe restriction of hip functions when attempting to withdraw, visualization of a large trochanter above the Roser-Nelaton line.

The most common signs of dysplasia that can be observed in newborns include:

1. a symptom of a "click" (slippage);
2. There is no symmetry in the folds of the skin on the hips of children;
3. limited passive hip removal;
4. the establishment of the lower extremity in the external rotation position (that is, the newborn's foot is turned outward);
5. shortening of the affected lower limb in comparison with the healthy one.

The formed dislocation of the femoral joint is characterized by the weakening of the gluteus muscles (because of which outwardly one leg becomes shorter than the other). Until a year, sick children are unstable or limp when walking, and in a bilateral process there is a "duck" gait.

If there is no ossification or a delay in the development of ossification nuclei is bilateral, this pathology of the joints is not considered a serious problem.

However, in the case of unilateral defeat of nuclei with significant contrast against the background of the other, immediate treatment in a specialized department is required.

Diagnostic tests

If such violations are detected, the risk of traumatic injuries or various joint diseases in the future increases. To prevent unpleasant consequences, it is necessary to contact a qualified specialist as early as possible and receive adequate treatment.

As a preventive measure, it is necessary to create comfortable conditions for the child

Even with a small suspicion of a violation of the norm or the absence of nuclei of ossification of the hip joints, orthopedists prescribe an ultrasound to confirm the diagnosis.

Sonographic research today is the safest for the health of the child and effective diagnostic method for determining the nucleus of ossification in the head of the femur and evaluating its functions.

In case of doubt, if necessary, use an X-ray examination in a direct projection, with which received information on the condition of the zone of ossification of the hip joints is more reliable.

However, it must be remembered that X-rays can be used in infants over three months old.

Healing measures

After correct and, most importantly, timely diagnosis, the orthopedists are prescribed a set of therapeutic measures, which, as a rule, must include:

• Prophylactic and therapeutic measures against rickets of children (ultraviolet irradiation, vitamin D intake).
• Wearing a special tire to more correctly position the components of the hip joints in relation to each other and their harmonious development.
• The appointment of a calcium complex in the form of electrophoresis with phosphorus and calcium, as well as bischofite in the region of the hip joints.
• Massage and therapeutic gymnastics babe.
• Electrophoresis with euphilin in the region of the lumbosacral spine.
• Baths with dissolved sea salt.
• Application with paraffin on the area of ​​the affected hip joint.
• Repeated ultrasound after treatment.

During the treatment of ossification of the joints, the child should not be allowed to sit or stand alone with an emphasis on the legs. This can lead to loss of the resulting improvements in treatment. The child needs to create a safe environment and not leave him unattended.

Prevention of pathology

Preventive measures should be as follows:

1. balanced nutrition of the mother, containing all the necessary nutrients, minerals and vitamins during pregnancy and lactation;
2. timely introduction of complementary foods in the diet of children (at 5 months, at most 7 months);
3. regular carrying out of massage and gymnastics for children;
4. walks in the fresh air and hardening;
5. preventive vitamin D intake up to a year (always in the autumn-winter period);
6. regular visits to the district pediatrician for a scheduled physical examination.

If the nucleus of ossification is absent or slowed down (that is, hypoplasia or aplasia is observed), then this can become a trigger factor in the development of a more serious pathology in the future. However, usually, if you comply with all the prescriptions of the doctor, the delay in ossification in children fades out within 7-8 months and the baby's bones develop agreeing to the prescribed norms.

A source: http://ProKoksartroz.ru/patologii/jadra-okostenenija-tazobedrennyh-sustavov

When there are nuclei of ossification of the hip joints in newborns?

The rudiments of nuclei in the articular bag of the hip articulation appear during the third and fifth months of pregnancy.

Since it is during this period that the formation of human bone tissue takes place. In newborns, ossification nuclei reach three to six millimeters in diameter.

There are cases of development of nuclei only by the eighth month of pregnancy. Therefore, it is so important that the child is born full.

A full development of the hip joint lasts up to 20 years. But by five to six years, the nucleus should be ten times greater than at birth.

In the absence of this standard, there is a need to check the pathology of development.

Role and function in the body

The absence of nuclei of ossification of the hip joints in infants or their insufficient growth to a year can provoke problems with the development of the musculoskeletal system.

Normal growth and functioning of the ball of the joint affects the correct development of the pelvis as a whole. To allow the child to learn to walk, keep the trunk in a level position.

Pathological condition of nuclei

The delay in the formation of the nuclei of ossification of the hip joint or their complete absence in the newborn in most cases is a serious pathology.

Which subsequently significantly affects the development of the joint.

The doctor when examining the baby looks at his health, which determines in which cases the slow growth of the nuclei - pathology, and when - the norm.

In the absence of hip dislocation, the slow growth of the balls in the joint is not generally regarded as a dangerous pathology. But for serious violations of the musculoskeletal system, the presence of a dislocation due to the absence of balls in the joint, it is necessary to begin treatment immediately.

Reasons for abnormality

Cases when there are late ossification nuclei or there is a delay in their growth can be triggered by a number of reasons. The basis of this pathogenesis is:

• diabetes;
• pathological disorders in metabolism;
• thyrotoxicosis;
• rickets (occurs in half of newborns);
• artificial nutrition.

In most cases, inadequate development of the nucleus is accompanied with such a congenital pathology as dysplasia of the pelvic joint.

Most often this dislocation of the hip joint is affected by girls.

In this case, the head of the femur and the center of the nucleus do not coincide, there is an underdevelopment of the cavity and the proximal part of the hip bone.

The causes that cause dysplasia and underdevelopment of nuclei:

1. infectious lesions during pregnancy;
2. hereditary factors;
3. old age of mother;
4. severe toxemia during pregnancy;
5. the position of the child's buttocks forward.

Dangerous symptomatology in case of underdevelopment of nuclei

Dysplasia develops during pregnancy, but after birth, against the background of this pathology, a dislocation of the head of the hip bone arises as a result of the load on the articulation. It is the dislocation that is a dangerous symptom in the problems with the development of the pelvic nuclei.

There are such types of bias:

• Precipitations- there is limited ability to dilute the child's legs, which before fold at an angle of ninety degrees. The tonus of leg muscular tissue is increased, there is no symmetrical arrangement of folds on the hips and buttocks.
• Subluxation- shortening of the leg in relation to the other, a sensation of clicking when leading the femoral bone (slipping of the head of the bone in the cavity of the joint).
• Dislocation- obvious violations in the period of walking (muscle tension, limited functionality of the thigh at the time of the leg, etc.).

With the formed displacement of the joint, the weakness of the buttocks is observed, as a result, one limb is shorter than the other. Up to a year, children can limp, and with a bilateral lesion the baby has a duck walk.

With the bilateral pathology of nuclear development, doctors do not consider this a serious problem. What can not be said about the unilateral underdevelopment of the joint.

Diagnostics

If you observe the symptoms of a pelvic development described above in your child, you should immediately contact an orthopedist.

He examines the child, interrogates the anamnesis of complaints, features of the course of pregnancy. Then an ultrasound examination is assigned. It is the most safe for the baby and informative.

With the help of ultrasound it is possible to obtain data on the presence and size of ossification nuclei, to determine their functionality.

In rare cases, the doctor prescribes an X-ray. With its help, the zones and parameters of ossification of the hip joint are more clearly visible. But X-rays have harmful radiation on the children's body, so it is not recommended for children, especially up to three months.

Methods of treatment

After diagnosis, appropriate treatment is prescribed.

An important point is that the baby is forbidden to sit or walk on his own, resting on his feet.

These actions contribute to the loss of the results of treatment. Therefore, the parents' task is to organize a safe pastime for the child.

Treatment measures:

1. Prophylaxis or treatment of rickets (to drink vitamin D, ultraviolet irradiation also helps).
2. It is necessary to wear a special tire, through which the correct arrangement of parts of the hip joint is achieved among themselves, as well as their adequate development.
3. Electrophoresis with phosphorus, calcium and bischofite in the joint region.
4. Massages and exercise therapy.
5. Procedure for electrophoresis with euphilin on the lower back and sacrum.
6. In the bath add sea salt.
7. Paraffin lining at the location of the joint.
8. Periodic ultrasound - diagnosis for the study of the dynamics of the disease.

With all the prescriptions of the doctor, all violations with the development of nuclei usually take place within seven to eight months. To prevent problems, one should adhere to a couple of preventive measures:

• a balanced diet for a pregnant and lactating mother;
• the correct diet of the child (complementary feeding is introduced from five to seven months, not later);
• massages for babies;
• walks in the open air;
• admixtures of vitamin D in the period of autumn, winter and spring;
• monthly examinations of the pediatrician.

A source: https://prospinu.com/anatomija/jadra-okostenenija-tazobedrennyh-sustavov-norma.html

The core of ossification of the hip joint

The musculoskeletal system plays a huge role in human life. It enables a person to easily move around in space.

Often the greatest attention is paid to the hip joints, as the disruption of their development entails very unpleasant consequences, directly related to walking.

Being in the womb, the fetus begins ossification of the hip joints and lasts for almost 20 years.

All this sometimes occurs in children born on time. This problem has a pathological character.

When the nuclei do not ossify in the first year of life, the joint does not develop fully, which can lead to disability in the future.

At the time of the birth of the child, the size of the cores is from 3 to 6 millimeters, and the main ossification falls on 4 to 6 months of life.

In girls, these processes can occur earlier than in boys, as according to statistics they outstrip them in development for about a month.

If there is a delay in ossification, the baby should be immediately shown to a qualified specialist. It will help to find out the cause of the pathology and will prescribe methods for its rapid elimination.

Causes

To date, there are a number of factors that provoke and lead to abnormalities in the development and ossification of the joints. The main ones are:

1. diabetes maternal diabetes;
2. metabolic disease;
3. feeding by mixtures, not by the breast;
4. thyrotoxicosis;
5. rickets.

Often underdevelopment of the hip joints is diagnosed with dysplasia.

Dysplasia is a disease due to which there is a lack of formation of the acetabulum and proximal parts of the femur.

In addition, the lack of vitamins of group B and E, as well as macro elements such as:

• iron;
• calcium;
• iodine;
• phosphorus.

The appearance of the disease is provoked by the following reasons, such as:

1. infectious diseases during pregnancy;
2. return of the mother over 40 years;
3. the bearing of twins or triplets;
4. severe toxicosis;
5. heredity;
6. premature delivery;
7. gynecological problems (tone of the uterus);
8. severe hormonal disorders;
9. large fruit.

Formation

The process of formation and development of nuclei proceeds imperceptibly for parents and is painless for crumbs. The period of ossification of the nuclei is divided into the following stages, such as:

• The first stage begins in the womb, during this period the joint consists of cartilaginous tissue, and it has significant differences from the structure of the joint of an adult person.
• The next period is about six months. For this period, the maximum increase and development of the nuclei of ossification of the hip joint is observed and, as a rule, it ends with the existence of the child.
• The third, final stage, it lasts until puberty, in the period when the individual nuclei join the plates. After this, the ossification of the lower and central parts of the acetabulum occurs.

There are cases when there is a delay in the development of the nuclei, and it is virtually impossible to see it visually. Often in this situation, they are, but the process of ossification is slightly slower than, with normal development.

Very problematic and dangerous is the situation where the core of ossification is not determined. In this situation there is no ossification of the joint, limbs become not symmetrical, and the performance of any movement becomes impossible. This can lead to disability of the child.

Diagnosis of abnormal development

Diagnosis of abnormal development of the femoral joints can be done on examination.

For this limb, the baby is straightened and joined together, and then the wrinkles on the hips and under the buttocks are studied, special attention is paid to symmetry.

The location of the folds at different levels indicates an incorrect development of the joint.

And also the problem can be determined during special exercises.

The child is laid on the back and the legs are bent, followed by pressing them to the tummy, and then gradually dilute the limbs on the sides and make a circular motion.

If there are no deviations, then the process of implementation is not difficult and does not cause discomfort in the baby. In the presence of a pathological process, this manipulation will be severely limited, and there may also be clicks and crunches.

Ultrasound of joints

This procedure can be done at home, but it is important to perform it smoothly and very carefully, so as not to harm and not injure the baby.

If the slightest sign of any pathology arises, you immediately need to show the baby to a qualified specialist who will conduct the examination, and will give directions for performing ultrasound. With the help of ultrasound diagnosis, the condition of the hip joints and the stage of their ossification can be assessed.

Treatment

Timely detection of disruption of nuclear development greatly increases the chances of a rapid elimination of the problem and avoidance of unpleasant consequences. For this purpose, the following treatment methods are prescribed:

1. intake of vitamin D for the prevention of rickets;
2. wearing special means, for fixing joints:
3. electrophoresis;
4. massage;
5. gymnastic exercises;
6. paraffin applications.

If suspected of having a disease such as rickets, in addition to taking vitamins, ultraviolet irradiation is prescribed.

Orthopedic drugs are used for treatment, such as:

• tires;
• stirrups;
• pillows;
• apparatuses.

Instruments help to keep the legs in the same position, mostly they are divorced legs to the sides.

Massage

When the joint is not yet ossified, the massage movements are performed without sudden movements. Often it's calm stroking and rubbing the skin.

If the baby wears an orthopedic device, then before performing the procedure, it must be removed. There are special rules for performing this procedure.

The main ones are:

1. The surface on which the baby lies will necessarily be flat and firm;
2. lay a massage table with a special waterproof diaper that can quickly absorb urine;
3. It is necessary to conduct a full course of therapy, which consists of 10, and sometimes 15 sessions;
4. Do not perform the procedure when the child is hungry or in a bad mood.

Remember to perform the therapy should be a specially trained person who knows the skills and knowledge in this area. He will be able to choose the right massage complex suitable for your baby.

Gymnastics

Together with a massage, perform gymnastic exercises. Such a complex of measures will help to get rid of the disease as quickly as possible and will speed up the process of normal joint formation.

Correctly pick up the exercises will help the orthopedist or the attending pediatrician. For best effect, do gymnastics several times a day. Often this method of therapy causes them delight and joy.

Very often the complex of the following exercises is assigned:

1. Put the baby on your back. Take the legs into your arms and bend them slightly by pressing the limbs towards the tummy. Then very smoothly spread apart and perform circular motions. When diluted, they should torso the surface.
2. Turn the baby on his stomach. And perform the above exercise, while gently press the pal in the palm to the plane on which the baby lies.
3. Lying on the back bend the straight legs, touching them with the baby's head.
4. Straight, straightened legs are bred to the sides.
5. Straighten the legs to the head. In the raised position, spread them apart.
6. In turn, bend the legs in the knees and hip joints.
7. Turn the child on his tummy. In turn, pull his legs to the pelvis, putting on the foot.

Paraffin

The implementation of this manipulation contributes to the elimination of toxic substances, and also promotes the normal development of bone tissue and ossification.

To perform therapy, you need to take paraffin, which has been specially processed, it is sold in a pharmacy.

The duration of the manipulation starts from 15 minutes and reaches half an hour.

Procedure:

1. take two saucepans and make a water bath, and melt the paraffin on it;
2. cool the resulting composition to a temperature of 60 degrees;
3. Wash the application site with warm water, and then lubricate with petroleum jelly;
4. on a cotton cloth, apply a small layer of paraffin and attach to the skin, and wrap everything with cellophane;
5. put warm panties on the baby and put it in the crib.

After performing the paraffin application, do not put the baby on the street, as the body is very warm and there is a huge chance of getting sick. Do not perform the procedure without prescribing a doctor, you can harm the baby.

Prevention

To avoid this problem, you need to take the following preventive measures, which are not only for babies, but also for their mothers:

• correct nutrition, saturated with useful vitamins during pregnancy and lactation;
• daily walks with the child in the fresh air;
• reception of vitamin D;
• regular visit to the pediatrician;
• performing gymnastic exercises and massage.

That the child was healthy, the mother must be attentive to his condition and bring the child to all necessary examinations.

A source: https://nogi.guru/raznoe/anatomiya-i-fiziologiya/jadro-okostenenija.html

Formation and development of TBS

The hip joint is formed in children in the womb and lasts for the first year of life.

The tissues of the hip joint are laid with the fetus on the sixth week of its development. The embryo develops mobility in the joint in two months. The intrauterine period and the period of the first year of a person's life are the most important for the development of the hip joint.

At the term of pregnancy 3-5 months, the nuclei of ossification form, that is, the formation of bone tissue hip joint, at the time of birth of a full-term baby, the ossification nucleus has a diameter of 3-6 millimeters.

In the infant, the joint is represented by a cartilage, an acetabulum, a femoral head, and part of the femoral neck has a mostly cartilaginous structure.

In babies born, the acetabulum is oval in shape, shallow, only a third of the head of the hip bone can fit into it.

The head of the femur is held in the acetabulum by the ligament apparatus and the tension of the joint capsule.

In the first year of life there is a stabilization of the hip joint, the angle of the acetabulum The neck of the femur ossifies, the centralization of the head of the joint occurs, the ligamentous apparatus is strengthened.

From 4-6 months the nuclei of ossification are actively formed. By the age of 5-6 years, the nucleus of ossification increases approximately tenfold.

By 14-17 years, the cartilage is replaced by a bone. The neck of the hip grows to 18-20 years due to the cartilaginous zones.

In an adult, the growth of the hip bone ends, the cartilage is completely replaced by a bone.

More in a separate article: joint dysplasia.

Causes of development of dysplasia in children

In the mother's morning, the joint can form incorrectly for a variety of different reasons, so they are listed below:

• genetic causes (25-30%),
• a large fruit,
• water scarcity,
• multiple pregnancies,
• pelvic,
• transverse,
• breech presentation of the fetus,
• violation of the mother's exchange processes.

And the lack of vitamins in the mother especially calcium and phosphorus, iodine, iron, vitamins E and group B. Here it is necessary to add:

1. endocrine disorders during pregnancy,
2. gynecological problems of the mother,
3. hormonal disorders (much progesterone in late pregnancy, the factor is especially important for girls),
4. viral and infectious diseases of the mother,
5. intrauterine cord with umbilical cord,
6. multiple pregnancies,
7. transverse position of the fetus,
8. malnutrition and bad habits of the mother,
9. early toxicosis,
10. late toxicosis,
11. heart defects,
12. disruption of the cardiovascular system,
13. premature delivery,
14. adverse ecology,
15. underdevelopment of the spine,
16. spinal cord,
17. increased uterine tone,
18. limiting the mobility of the fetus at the end of pregnancy.

Degrees of dysplasia tbs

Dysplasia of TBS in children can be expressed in varying degrees.

Pre-exertion (grade 1)characterized by the pathology of only the acetabulum, the femur is not biased, but the pathology is determined clinically and radiological.

Subluxation (2nd degree)differs in the displacement of the femur, part of which remains in the acetabulum.

Congenital dislocation (grade 3)dysplasia tbs characterized by the location of the head of the femur beyond the acetabulum.

With a normally developed joint, the legs of the baby are well diverted to the sides, have the same length, do not have a restriction, the same number of wrinkles on the legs are characteristic.

With subluxation, the abduction of the femur with pathology is limited, with the dislocation formed, the restriction is strongly pronounced. If there are any symptoms of dysplasia tbs is worth a thorough diagnosis.

Diagnosis of dysplasia in children

The diagnosis of the disease is X-ray studies, planned ultrasound studies.

Ultrasound is usually done in three months, the X-ray can be done directly in the hospital if there were any suspicions of dysplasia tbs.

The treatment of dysplasia is the more effective the earlier it was started.

Today, successfully using such means as:

Tire Cough(contributes to the centering of the head of the joint, fixes the thighs in a dilute state, but gives the baby the opportunity to actively move in the hip joints)

The stirrup of Pavlik(tissue chest bandage, contributes to the centering of the joint head, strengthens the ligaments of the hip joint, These stirrups the child does not straighten the legs, other movements are possible, effective in the period from six months to a year).

Freecock TireIt is used for mild forms of dysplasia in children who have not yet reached the age of six months, but is shown with a dislocation, it is designed so that the hips keep their position at an angle of ninety degrees.

In the treatment of other forms of dysplasia in children older than six months used a variety of tires (Koshlya, Vilensky, Mirzoyeva, Orlett, Gnevkovskogo apparatus, gypsum).

When dysplasia of the hip joint in children over the age of most often use gypsum to fix the legs in certain positions.

The position of Lorentz I─ fixing the legs bent at right angles in the hip and knee joints with full hip extension to the plane of the bed.

Regulation II─ Moderate controlled retraction of the hips bent at an angle of 90 ˚.

Regulation III─ slightly outstretched legs in straightened condition. When a child reaches a year and a half, if dysplasia of TBC is not defeated, usually an operation is prescribed (more often "according to Salter").

It is advisable to use exercise therapy even in the absence of pathology, if the child has a genetic predisposition to dysplasia, in such cases effectively exercise exercise therapy without stress on the joints lying position.

In any case, parents whose babies have dysplasia tbs do not despair, but one has to have patience and strength to overcome difficulties. And this will necessarily happen, if in a timely manner, under the supervision of a doctor, conduct competent therapy.

The following articles will also be useful:

- Dysplasia - full information

- Development of the child in conditions of restriction of mobility

- Emotional state of parents

- How to prepare a child for surgery

A source: http://dysplazia.ru/poleznoe/formirovanie-i-razvitie-tbs