Congenital dislocation of the hips is a common pathology of 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 serious developmental defect.
The reasons may be:
- defects of primary lining during intrauterine development of the fetus;
- genetic defects;
- complicated pregnancy: toxicosis, nephropathy, metabolic disorders, cardiovascular pathologies;
- pelvic presentation of the fetus;
- tight swaddling.
From the time of detection of dysplasia, the outcome of treatment depends, since the earlier it begins, the more effective the result will be. Every month of delay is threatening irreversible consequences. Diagnosis of congenital dislocation of the hip should be carried out even in the hospital. All babies need an examination of the pediatrician, if necessary - an orthopedist. Repeated consultation is carried out in a month, then in two. In some countries, in order not to miss the pathology, all children born to take 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 homes. 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 allow to suspect a pathology in time.
The main symptoms of the disease during clinical examination of the child are:
- limitation in hip joint management;
- click, slip;
- asymmetry of folds on the buttocks, thigh;
- different length, shortening of legs;
- rotation of the foot: it is as if turned outward;
- late onset of walking (14-15 months);
- characteristic gait: instability, lameness, pumping like a duck;
- trendelenburg syndrome: when resting on a dislocated leg, the opposite halves of the buttock lower, normal - it should rise;
- the thigh head is not probed at the site of pulsation of the femoral artery;
All the symptoms can be combined or there may be one. If there is a suspicion of 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.
Diagnosis of all dysplasias should be performed from diapers, including congenital dislocation of the hip. Treatment is complicated with each subsequent month of life of the child. It is desirable that a newborn with such a pathology before receiving a special discharge tire lay only on the back, spreading legs to the sides. The use of tires is the most optimal method of treatment. Since these devices, unlike gypsum spacers, are lightweight, can be sanitized, they make it possible to change the angle of the legs, allow swinging movements. The duration of their wearing is up to six months, then a deepening of the acetabulum is noted. In addition to tires, only new swaddling equipment 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 (from the year), the congenital dislocation of the hips is manually adjusted, using anesthesia and applying subsequent gypsum, overlapping tires. Duration of treatment - from eight months to a year. Now this method is almost not used, as it causes many complications. Less traumatic is non-narcotic gradual extension.
The accompanying treatment 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 earlier the operative intervention is undertaken, the higher the probability of complete cure.
Early diagnosis allows you to restore the hip joint by 100%. At later terms, 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 be limping, constant pain, the formation of contractures, ultimately - disability. Deterioration, disease progression is observed during hormonal outbreaks: 7, 12-15 years, during pregnancy and lactation.