Congenital dislocation of the hips is a common pathology of hip joint deformity associated with their underdevelopment, i.e. dysplasia. It occurs several times more often in girls than in boys. Considered a severe developmental defect.
Reasons
Reasons can be:
- malformations of the primary bookmark during fetal development;
- genetic defects;
- complicated pregnancy: toxicosis, nephropathy, metabolic disorders, cardiovascular pathologies;
- breech presentation;
- tight swaddling.
Diagnosis
The outcome of treatment depends on the time of detection of dysplasia, since the sooner it starts, the more effective the result will be. Every month of delay threatens with irreversible consequences. Diagnosis of congenital dislocation of the hip should be carried out in the hospital. All babies need to see a pediatrician, if necessary - an orthopedist. A follow-up consultation is held in a month, then in two. In some countries, in order not to misspathology, all born children take pictures, ultrasound of the hip joints.
The key to successful diagnosis, early detection of dysplasia is a strong relationship between obstetricians, orthopedists and pediatricians in maternity hospitals. All children need a systematic examination. During this period, it is difficult to determine the congenital dislocation of the hips in a child, there are almost no symptoms. Only a certain skill of doctors, their joint work will make it possible to suspect a pathology in a timely manner.
The main symptoms of the disease during a clinical examination of a child are:
-
congenital hip dislocation treatment restriction in hip abduction;
- click, slip;
- Asymmetric folds on the buttocks, thigh;
- different length, short legs;
- rotation of the foot: it seems to be turned outward;
- late start of walking (14-15 months);
- characteristic gait: unsteady, lame, pumping like a duck;
- Trendelenburg's syndrome: when resting on a sprained leg, the opposite half of the buttock is lowered, normally it should rise;
- femoral head is not palpable at the site of pulsation of the femoral artery;
- rickets.
All symptoms may be combined or there may be one or the other. If you suspect a congenital dislocation of the hips, it is better to immediately take an x-ray. The examined disease threatens the child with severe disability in the future.
Treatment
Diagnosis of all dysplasias should be carried out from the cradle, including congenital dislocation of the hip. Treatment gets more difficultnext month of the child's life. It is desirable that a newborn with such a pathology, before receiving a special abduction splint, lies only on his back, spreading his legs to the sides. Splints are the best way to treat.
Because these fixtures, unlike gypsum spacers, are lightweight, can be sanitized, make it possible to change the angle of spreading the legs, and allow rocking movements. The duration of their wearing is up to six months, then there is a deepening of the acetabulum. In addition to tires, for newborns and infants, only the wide swaddling technique should be used. The legs should be free, and the arms can be wrapped tightly in a blanket.
For older children (from one year old), congenital hip dislocation is reduced manually, using anesthesia and subsequent plastering, splinting. Duration of treatment - from eight months to a year. Now this method is almost not used, as it causes many complications. Less traumatic - anesthesia-free gradual traction.
Associated procedures – physiotherapy, massage, special exercises. An unsuccessful attempt to correct dysplasia in a conservative way ends with an operation. Its essence is the restoration of the correct structure of the hip joint. The sooner surgery is undertaken, the higher the chance of a complete cure.
Consequences
Early diagnosis allows you to restore the hip joint by 100%. At later stages, treatment is not so effective, buthelps improve the quality of life. If you do not pay attention to the problem, then the child will have lameness, constant pain, the formation of contractures, and ultimately disability. Deterioration, progression of the disease is observed during hormonal surges: 7, 12-15 years, during pregnancy and lactation.
