Congenital dislocation of the hip is the most common form of congenital disorders. If the child, in addition, the underdeveloped acetabulum, which forms the cavity of the hip joint, it is dysplasia of the hip joint. Against the background of dysplasia, if timely measures are not taken, dislocation is formed over time.
When dysplasia, violations are observed in all the elements of the thigh: acetabulum, femoral head with surrounding muscles, ligaments, capsule. These changes in them are associated with the underdevelopment of tissues. The development of dysplasia (some of which is formed in the dislocation) is due to insufficient interaction between the acetabulum and the femoral head in the intrauterine stage of development of the thigh.
Congenital hip dislocation is more common in girls. It is believed that the development of dislocation is facilitated by the mother's diseases during pregnancy (toxicosis, nephropathy), as well as the wrong position of the fetus (for example, pelvic).
Symptoms of this disease can and should be noticed by the parents themselves. This is the asymmetry of the folds of the skin on the hips and buttocks, the difference in the length of the legs. When the legs are bred to the sides, in the supine position, a click is heard, the restriction of the hip dilatation. In norm, in infants of the first months of life, the thighs are easily bred at 80-90 degrees. External rotation of the foot - with this symptom of the foot, on the side of the dislocation, as it were turned outward. This is especially noticeable during the child's sleep. If dysplasia is not diagnosed in time, the manifestations of the disease only appear when the baby stands on the legs. These babies go walking later than others, and walking around them is shaky: when you dislocate from one side, the child limps on one leg, and when two-sided - waddles like a duck. To confirm or exclude a diagnosis at the age of 2-3 months, x-rays of the hip joints are performed.
Treatment should be started as soon as possible and under constant medical supervision. In the early stages of the disease, during the first three months of the child's life, a wide swaddling is used. Between the bent at the joints and the hips withdrawn put a folded four-fold diaper. It is fixed between the thighs with panties, a diaper. You can also use special tools. It happens that a wide swaddling is not enough (this can only be determined by a doctor), then the stirrups are used to fix the legs, in which the child will be until fully recovered. With the onset of dislocations, surgical intervention is performed.
Treatment by position .
- The child's bed must be flat and semi-rigid.
- With insignificant dysplasia, during the first three months of life the child is using a wide swaddling.
- Since in the prone position on the abdomen, the feet are bent and bent, they should protrude beyond the edge of the bed, otherwise the spasm of the muscles - the adductor of the hips - increases.
- Starting from 6-7 months, parents should sit the child with legs apart, kneeling face to face. At the same time, it is necessary to support the baby behind the back.
- When a mother walks or stands with a child, then with one hand she should support him by the back, holding the child to her, and the other hand under the buttocks. In doing so, the child's legs should cover the torso of the mother. You can also use "kangaroo", although prolonged wearing in it leads to a steady retreat of the forefoot outside.
- The starting position - the child lies on his back, feet to the masseur (mom). The legs of the child are bent in the knee and hip joints and soft plastic hip dilatation with simultaneous acupressure to relax the leading hamstrings. Pads of nail phalanges of 2 and 3 fingers or one 3 fingers of the hand, the mother touches the skin in a place corresponding to the projection of the hip joint on the side, so as to feel a depression when pressed, and then gently and slowly exerts a rotational and soft pressing pressure on the point ); all the hip of the child clasps the palm and fingers of the same hand, the first finger lies easily in front on the inner surface of the thigh. Relaxation of the adductor muscle is carried out by a simultaneous point, vibrational massage of the point (it is 2-3 cm below the inguinal fold) and a slight shaking of the child's thigh with the remaining fingers (the child's thigh lies on the palm of the masseur). Simultaneously with the massage and shaking the hips of the bent leg, the hip is gradually removed from the outside.
- The starting position is the same. The masseur with one hand fixes the child's hip joint (with the left hand - the left one, the right one - the right joint), bent by the hand of the other hand gently covers the child's knee and makes a slight rotation of the thigh along its axis inward with simultaneous plastic light pressure on the knee, the shin is somewhat outwardly guided. This exercise achieves a gentle pressure of the femoral head on the acetabulum.
- The starting position - the child lies on his stomach. The masseur fixes the child's pelvis slightly with one hand, placing the palm of his left hand on the right buttock of the child, with the other hand, seizing the shin, doing the right leg bend in the knee and hip joints. The same - the other leg. In this position and at this position, movements in the hip joint are as easily achieved as possible in the fullest possible extent.