Congenital dislocation of the hips is a common pathology of the deformation of the hip joints associated with their underdevelopment, i.e., dysplasia. In girls, it occurs several times more often than in boys. It is considered a severe developmental defect.
Causes
The reasons may be:
- malformations of the primary bookmark during fetal development;
- genetic defects;
- complicated pregnancy: toxicosis, nephropathy, metabolic disorders, cardiovascular pathologies;
- pelvic presentation of the fetus;
- tight swaddling.
Diagnostics
The outcome of treatment depends on the time of detection of dysplasia, since the sooner it starts, the more effective the result. Each month of delay threatens with irreversible consequences. Diagnosis of congenital dislocation of the hip should be carried out in the hospital. All babies need a pediatrician examination, orthopedic surgeon if necessary. Repeated consultation is carried out in a month, then - in two. In some countries, in order not to miss the pathology, all born children are taken pictures, ultrasound of the hip joints.
The key to successful diagnosis, early detection of dysplasia is a strong connection 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 the child, there are almost no symptoms. Only a certain skill of doctors, their joint work will allow to suspect pathology in a timely manner.
The main symptoms of the disease during a clinical examination of a child are:
- restriction in abduction of the hip joint;
- click, slipping;
- asymmetry of the folds on the buttocks, thigh;
- different lengths, shortening legs;
- foot rotation: it is as if turned outward;
- late start of walking (14-15 months);
- characteristic gait: instability, lameness, pumping like a duck;
- Trendelenburg syndrome: when resting on a sprained leg, the opposite half of the buttock is lowered, normal - it should rise;
- the femoral head is not felt at the site of pulsation of the femoral artery;
- rickets.
All symptoms may be combined or one may be present. If you suspect a congenital dislocation of the hips, it is better to immediately take a radiography. The observed disease threatens the child with severe disability in the future.
Treatment
Diagnosis of all dysplasias should be carried out from the diaper, including congenital dislocation of the thigh. Treatment is complicated with each subsequent month of the child's life. It is advisable that a newborn with such a pathology, before receiving a special abduction tire, lay only on his back, legs spread apart. The use of tires is the most optimal treatment.
Since these devices, unlike gypsum struts, are lightweight, they can be
sanitized, make it possible to change the angle of breeding of the legs, and they 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, only the swaddling technique should be used for newborns and infants. The legs should be free, and the handles can be tightly wrapped in a blanket.
For older children (over a year), congenital dislocation of the hips is adjusted manually, using anesthesia and the use of subsequent casting, applying tires. The duration of treatment is from eight months to a year. Now this method is almost never used, as it causes many complications. Less traumatic - anesthetic gradual traction.
Concomitant treatment procedures - physiotherapy, massage, special exercises. An unsuccessful attempt to correct dysplasia in a conservative way ends in surgery. Its essence is the restoration of the correct structure of the hip joint. The sooner surgery is undertaken, the higher the likelihood of a complete cure.
Effects
Early diagnosis allows you to restore the hip joint by 100%. At a later date, treatment is not as effective, but it helps to improve the quality of life. If you do not pay attention to the problem, then the child will have lameness, constant pain, contracture, and ultimately disability. Deterioration, progression of the disease is observed during hormonal bursts: 7, 12-15 years, during pregnancy and lactation.