Child development takes place rapidly to a year: every day brings something new.The kid sits down, starts to crawl, stands on legs ... finally takes the first step.Delight and supplication parents there is no limit.Sometimes, however, soon after that happy event it becomes clear that a walk is not all right: the child strangely puts leg or limping, or rolls over while walking.What is it?This is likely to hip dysplasia symptoms. Content
hip dysplasia (TPA), or congenital subluxation of the hip called hypoplasia (or abnormal development) of the joint or its components: the acetabulum of the pelvic bone, cartilage, ligaments and muscles that hold the thigh bone in the correct position.
When underdevelopment joint is broken or missing the proper contact between the femoral head and the groove for it (the acetabulum in the pelvic bone).The manifestations of this disease is sometimes difficult to
In the absence of contact between the femur and pelvic bone, the femur can move freely out of the joint.This condition is called a dislocation of the joint, or dislocation.There are two subspecies of dislocation: Teratological and typical.
Teratological develops in utero due to genetic diseases or abnormal development of muscle tissue.It is rare.Typical dislocation is characterized by having contact between two bones, but it is incomplete, unstable.This pathology of the most common and can occur both in utero and after birth in healthy newborns.
Subluxation - less serious condition: the contact between the bones in the normal range, but the joint is unstable, and the femur is easily separated from the acetabulum.
real reason for abnormal development or underdevelopment of the joint is not fully known.
Contributing factors are:
Pathology of joints in the normal position of the legs does not cause the baby any unpleasant or painful sensations.Because of this, parents noted the underdevelopment of the joints in the early stages is difficult.
first manifestations of disease can occur when the child begins to walk.When TPA is marked on both sides swinging when walking or so-called "duck walk".When hypoplasia of one or both joints of the child may walk with a limp, walk "on tiptoe" (do not step on the toes).
At the slightest suspicion should be referred to a doctor who can determine the diagnosis not only through inspection but also the conduct of special procedures.When TPA reveal symptoms:
To confirm the diagnosis, a doctor during the inspection of suspected child apply:
additional examination is necessary to identify the TPA, because sometimes even the experienced doctor can make a mistake.So, according to statistics, pediatricians suspect this pathology in joints 8.6 cases in 1000, podiatrists - 11.6 cases, and ultrasonography revealed violations of the structure of joints in 25 children from 1000.
US - the predominant method of diagnosing disease of the hipjoint in the first months of baby's life: it is more informative than a simple medical examination, painless, does not exposure.The study makes it possible to see a clear shape of the pelvic bone cavity, which is of great importance in the development of dysplasia.
does not make sense to carry out ultrasound to 4 weeks of life of the newborn, for some changes in the structure of the hip disappear on their own without treatment within the first month of life.
Symptoms of TPA, which can be detected by other examination methods:
objectives of therapeutic measures in TTP:
Treatment after examination and diagnosis should be carried out immediately.The length and complexity of the therapeutic measures depend on the severity of dysplasia, the age of the child.Prescribe a children's orthopedic surgeon.
Depending on the severity and timing of diagnosis and treatment of TTP can be conservative and surgical.
Conservative treatment includes such variety of therapeutic measures:
There is a wide range of orthopedic aids , whose main purpose - to maintain the legs of a baby in breeding and bent position without limiting the movements of the child (which is very important).Orthopedic means hold the head of the femur in the correct position, and this ensures the formation of a normal joint.
The most popular of these tools - stirrups Pavlik .They are commonly used in children under 6 months of age.Efficiency means is about 85%, so at the time of their application must be medical supervision.
orthopedic devices Splinter fixes legs of a baby in a diluted state with metal fixtures that promotes the proper development of the joint.
Earlier in the practice of the treatment of children recommended wide swaddling baby: 2 folded diapers recommended lay between divorced legs and the third leg diaper fixed in this position.
However, convincing data on the effectiveness of the swaddling is not received.Some doctors recommend it and now.
In no case should not be tightly swaddled baby!With such a fixing leg underdeveloped mobile and flexible joints flips in and fused in this unnatural position.Better not to swaddle the child, and to wear them sliders small.
From physiotherapy methods treatment used: electrophoresis with calcium chloride, ozokerite applications, mud.Treatments help to strengthen underdeveloped joints.
Exercising used as a set of special exercises according to the stage of treatment and the age of the child.Good effect is swimming on his stomach.LFK contributes to muscular system and restoration of range of motion.
muscles of the hips and buttocks well strengthened correctly configured massage.
If the use of these methods of treatment with 3 months of age and up to 2 years did not produce results, it can be applied rigidly fixed to total immobility of the hip joint in the form of a bandage after koksitnoy closed reduction of dislocation way .Gypsum may be applied depending on the complexity of the case one of the three options: on foot and half to the other leg, two legs, or one leg.
Surgery is usually used in advanced dysplasia and the ineffectiveness of earlier treatments.Most often this happens in cases where the TPA is detected in a child older than one year already underway formed hip dislocation.Although in some cases, early detection and treatment of the disease is ineffective.
surgical interventions achieved the reconstruction of the hip joint.Operations can be carried out by different methods and are selected individually in each case.Sometimes, only one operation is carried out, and in another, more complicated case, there may be a need for a multi-stage surgery.
adopt the methods of surgical treatment:
Such examination (under anesthesia) may be carried out, and after the failure of the method Splinter to decide on further tactics of treatment (eg, reduction is carried out by open or closed).
After surgery, the child is in the hospital for several days.After the surgery is necessary for a long time to carry out rehabilitation treatment, which are used in the process of massage, physiotherapy, physical therapy.
With early detection and treatment of diseases from the first month of baby's life prognosis is quite favorable: Conservative treatment is effective, and 95% of children diagnosed with a year removed.
In case of failure of the treatment or diagnosis of TTP later consequences can be very serious, it is likely the child's disability.
If undiagnosed or untreated TPA can develop complications such:
The surest way to avoid serious problems and operations on the hip joint - the timely detection of congenital disorders and early onset of painless medical treatment.The possibility of full recovery of the child is directly related to the timing detection of abnormal development of the joints.
timely examination of pediatric orthopedics and ultrasound (at the slightest suspicion of pathology of the joints) will help confirm or rule out dysplasia.Do not be afraid to use orthopedic parents for the treatment of: firstly, they are completely painless, do not cause suffering child and, secondly, the child will easily get used to them.But they can help get rid of the disease by the year, and the child will be free to go.