The situation in which doctors diagnose a newborn with "hip dysplasia" today, alas, is not uncommon. Such a ominous-sounding diagnosis frightens and discourages parents. Doctor Evgeny Komarovsky tells what to do if the child has been given it.
About the disease
Dysplasia of the hip joint is an articular defect in which it is more mobile than a normal joint. This leads to dislocation or subluxation. The disease is quite common in the world. Among the Scandinavian peoples, about 4% of children are born with such a defect, and in the United States, about 1%. In Russia - 2-3% of babies have hip dysplasia, and among the Chinese and Africans, this ailment is practically not found.
In countries where it is still customary to swaddle tightly straightened baby legs, the incidence is higher than among peoples in whom swaddling is not practiced.
In girls, pathology is more common than in male children. According to medical statistics, such an ailment is recorded in children who were in breech presentation, as well as in children - firstborns. The joint on the left is affected more often than the right. In 20% of cases, both the left and the right are affected.
With dysplasia of the hip joints, the head of the femur physiologically cannot be retained in the joint capsule. With a slight exit from the cavity, doctors talk about subluxation, with complete - about dislocation of the hip.
An experienced doctor will see dysplasia at the very first examination of the baby, usually it is carried out in the first few days after discharge from the hospital.
The doctor will be able to suspect pathology by the following symptoms:
- The skin folds on the legs are asymmetric, uneven.
- The baby's hips are shortened.
- When the doctor tries to spread the legs in different directions, there is some restriction of movement. The breeding angle is also different.
- When the legs are pulled apart and separated, a distinct click is heard.
All these signs can be observed in perfectly healthy children, and therefore none of them is an independent basis for a diagnosis. Need x-ray, ultrasound, orthopedic examination.
Treatment of milder forms can be limited to wide swaddling, legs, massage and gymnastics. If the shape is more complex, the doctor recommends orthopedic devices, for example, Pavlik's stirrups. In some cases, surgical treatment or bloodless reduction of the joint is recommended, followed by a fixation complex.
"Dysplasia of the hip joint in children" - should young parents be afraid of such a diagnosis? More about this in Yevgeny Komarovsky's own show.
Komarovsky about the problem
Evgeny Komarovsky argues that modern orthopedists tend to somewhat exaggerate the problem and make diagnoses even in doubtful cases, even with minor doubts.
The fact is that 20% of children, to some extent from birth, suffer from various forms of a defect of the hip joint. Real dysplasia is much less common, and serious treatment requires 2-3 cases out of 1000.
Evgeny Komarovsky refuses to consider the disease congenital, since all the elements of the joint are in place, both softening and stretching of the ligaments are most often caused not by a defect in the structure, but by the hormonal background of the mother, in whom hormones are produced in the late stages of pregnancy that soften and stretch the ligaments for an easier birth process.
In the overwhelming majority of cases, according to Evgeny Komarovsky, treatment is not required, and after a while the joints return to normal in a completely natural way. Tight swaddling, genetic predisposition (if parents had similar problems in childhood) can interfere with this natural process.
Additional risk factors, according to Komarovsky, are the mother's age - after 35 years, congenital deformity of the baby's feet, birth weight over 4 kilograms.
Children born prematurely deserve special attention from pediatricians and orthopedists, as well as babies who were carried by mothers in "extreme" conditions - with severe toxicosis, against the background of taking various medications, even if the medications were prescribed by a woman's doctor. The risk group is also children born from multiple pregnancies, as well as babies whose mothers, while carrying crumbs, worked in hazardous industries or constantly live in ecologically unfavorable regions (where the frequency of such diagnoses can reach up to 12%).
The sooner existing joint instability is discovered, the better, Komarovsky believes, since the younger the child, the easier it is to correct his joint problem. Until 4 months, you should not do an X-ray examination, a harmless and informative ultrasound method is quite enough.
Treatment and prevention
Where there is no swaddling culture, such as in Africa, babies are carried from birth in a riding position, strapped to the back. And they didn't even hear about dysplasia there, says Komarovsky. It is this posture that will help correct imperfections in the structure of the joint, and will also be an excellent prevention of hip dislocation.
You can wear a diaper for your child one size larger than it should be, so that his hips always remain slightly apart. Therapeutic massage is very effective for minor stages of the disease.
Komarovsky advises parents not to sound the alarm and not panic. Dysplasia of the hip joint requires consistent and measured actions from them. In case of pre-dislocation, massage and electrophoresis can be dispensed with; in case of curvature, the doctor will insist on wearing orthopedic stirrups, and in case of dislocation, splints. The problem is solved in an operative way if the diagnosis is made late or the severity of the joint damage is great.
Evgeny Olegovich does not advise mothers and fathers to refuse the prescribed treatment, because the absence of therapy will not always have a positive effect in the future. The child may develop habitual lameness, pain in the pelvic joint and its deformation, the muscles of the legs may atrophy to one degree or another, in severe cases, the organs located in the pelvis may lose all or part of their functions.
Many of these consequences are disabilities. Therefore, it is better to take measures to prevent this scenario from developing at an early stage.
Tips
A child with a diagnosis of hip dysplasia should not be encouraged to stand and walk early. It will be better if the baby first learns to crawl steadily and perfectly.
The most effective treatment is considered to be under the age of one year.
Any treatment other than surgery makes sense for up to 5 years. After this age, it is not possible to talk about any other therapy other than surgery.
