Congenital dislocation of the hip - this anomaly of the lower extremities is very common. The cause of congenital hip dislocation is hypoplasia of all components of the hip. At the same time disturbed the normal relationship of the femoral head articular and the articular surface of the acetabulum of the pelvis. Girls suffer five times as likely as boys.
There are three stages of congenital hip dislocation:
Hip dysplasia - or unstable hip.
Congenital subluxation of the hip in the hip joint.
Congenital dislocation of the hip.
At birth the child is immature acetabulum, namely, not enough depth. The growth of the femoral head is slowed down. The position of the femoral head is broken. Accordingly, the slow and disrupted growth and development of muscles, ligaments and capsule of the hip.
Hip dysplasia should be identified immediately in the first weeks of life and prescribe treatment, or developed a subluxation, and by the time the child starts to walk, there is a congenital hip dislocation. Suspected hip dysplasia can be seen from the baby. To do this, the baby's legs, bent at the knee and hip joints, diluted at a right angle in the hip joints. In the presence of dysplasia or congenital subluxation of the hip - hip abduction with patient hand is limited. In the case of bilateral development abnormalities, restriction is also found on both sides, but most of dysplasia and the corresponding limitation of movement, sometimes one-sided.
Another sign of hip dysplasia - a violation of the symmetrical arrangement of the folds under her buttocks and thighs. Children podiatrist can detect when viewed from a symptom-click (Ortolani sign of Karl Marx). Click is felt at the time of breeding hips, with knees bent and feet hip. There is a click when the dislocation of the femoral head of immature acetabulum at a dilution of the thighs. When the baby's legs back to the middle line, reduce a hip again, accompanied by re-clicking. The child by the leg joint subluxation may look shorter.
A child with a congenital abnormality of the hip is usually too late to start walking. He is disturbed gait. Child limp on the leg with the patient side, his torso leaning in the same direction. This helps to correct violations of formation curves of the spine and the development of curvature of the spine - scoliosis.
Bilateral dislocation of the hip is characterized by a sort of "duck" gait. But the pain in the joints of children do not complain. In young patients diagnosed refine by ultrasound examination of the joints, which is preferred. It does not give X-ray load, and may already have a child with two weeks of age. Then, how to get informative X-ray can only be four patient's age, when there are points of ossification, which can be seen on x-rays.
Treatment of congenital dislocation of the hip. It is important to start treatment a young patient immediately after the detection of the disease. Assigned to physiotherapy, which trains the child's parents. Training is carried out 8-10 times a day. Conduct daily massage of the back, buttocks and thighs. It is used widely swaddling. In more severe cases, use special tires, whose role in keeping the hips of the child in the position of lead, which contributes to the proper development of the hip. When the results achieved by conservative methods fail, surgery is appointed.
