Recognize and treat hip dysplasia in the child

Recognize and treat hip dysplasia in the child

  • Hip dysplasia is either congenital or acquired and is manifested by an incompletely developed acetabular cup.
  • The earlier the malocclusion is recognized and treated, the better the chances of recovery and late effects can be avoided.
  • A slight hip dysplasia often develops on its own, while more severe cases are usually treated successfully with various measures and aids.

The diagnosis of hip dysplasia in the baby or child does not scare you. Because if the doctor starts treatment on time and you comply with the guidelines, they are Healing chances very well. They find out more about risk factors, therapy and treatment duration the disease.

1. Congenital or acquired malformation

In hip dysplasia, the femoral head of the femur is unstable in the acetabulum and can not support it.

Hip dysplasia in the baby and child is one Congenital or acquired malformation or maturation disorder of the acetabular cup. Their ossification takes place only delayed, whereby the femoral head of the thigh finds no stable support. In turn, the still soft acetabular cup is damaged or deformed.

A hip dysplasia can only on one hip joint or on both sides occur. About two to three out of 100 newborns are affected and five times more girls than boys.

The Hip dislocation is the most severe form of hip dysplasia – Here, the femoral head is partially or completely slipped out of the socket. A Treatment of both forms is essential, to avoid long-term consequences. As Consequential damage can be permanently damaged socket or femoral head, which can lead to premature signs of wear and tear, restricted mobility, pain, and later disability.

The hip is a ball joint and consists of the acetabulum and the cartilaginous-soft femoral head. This connects the hip and thigh. He is covered by the pan and can turn in it. Now is the “roof” of the acetabulum (and sometimes the femoral head) too small or underdeveloped or is the femoral head partially or completely outside the pan, the hip does not work properly – there is a hip dysplasia in the child or baby or a Hüftluxation in front.

2. Unclear causes, but known risk factors

There are different risk factors, which can promote hip dysplasia in children:

Gemini is at greater risk of developing hip dysplasia in the womb.

birth of the child in rump or breech position – This is 25 times more likely to hip dysplasia than normal birth position

  • birth risks – In premature birth, after caesarean section or too little amniotic fluid, the risk of a baby with hip dysplasia seems to be increased
  • tight conditions in the womb – For example, in a twin or multiple pregnancy
  • genetic predisposition – e.g. if the mother or older siblings already had hip dysplasia
  • hormonal factors – Girls in the womb are more sensitive to the pregnancy hormone progesterone, which can loosen the hip joint capsule
  • malformations – especially in the area of ​​legs, feet and spine
  • muscular or neurological disorders – For example, open back
  • through after birth Malpositions of the hip joints – Children carried on a sling develop RISTERLY to hip dysplasia
  • Note The earlier the child’s hip dysplasia is treated, the greater the chance that it will heal completely without any sequelae. Because the younger the child, the more malleable is the hip joint. But even if the treatment starts later, good results are generally expected.

    3. Clarify external signs with ultrasound

    Ultrasound is used to check if hip dysplasia is present in the baby and what type it is.

    Babies with hip dysplasia usually show no obvious symptoms. For this reason, the pediatrician examines whether a hip dysplasia is present in the child as part of the precautionary examination U2 on the third to tenth day of life. The following External signs may indicate the malformation:

    • different lengths of legs
    • Leg can not be spread as far as normal
    • the hip joint is unstable or stiff
    • the Skin folds on the thigh are asymmetrical
    • Click sound when turning the bent knee outwards

    All these Symptoms are no final proof yet, that your baby has hip dysplasia. Therefore, this will be in the 4th to 6th week of life clarified with the help of an ultrasound examination of the hip. This is completely painless and harmless for your little darling. In older children with hip dysplasia An x-ray examination may be necessary, to clearly recognize the malposition.

    4. Classification of hip dysplasia into different types

    With the aid of a classification based on two measuring angles, the condition of the ladle roof can be evaluated. This will be In the case of ultrasound, the ratio between hip socket and femoral head is measured. The alpha angle (α) stands for the acetabular roof angle and the beta angle (β) for the cartilage roof angle. From these values, the doctor can, together with the age of the child Assess the degree of hip dysplasia and initiate the necessary treatment:

    Type Alpha-angle Beta angle therapy
    Hip matured
    > 60 ° 60 ° 55 °
    • Therapy not required
    • regular inspection necessary
    • possibly spreading treatment
    50 ° – 59 ° > 55 °
    • spreading treatment
    endangered or critical hip
    43 ° – 49 ° 77 °
    • Spreading plaster required
    with malposition
    without structural disorder in the cartilage
    77 °
    • Einrenkung
    • Immobilization with plaster
    • possibly hospital admission
    with malposition
    with structural disorder in the cartilage
    77 °
    • Einrenkung
    • Immobilization with plaster
    • hospitalization
    complete dislocation
    77 °
    • Einrenkung
    • Immobilization with plaster
    • hospitalization

    Tip: The greater the value of the alpha angle, the better the condition of the hip joint. For example, at 58 degrees at the alpha angle, there is either a maturation or an ossification delay that, depending on the type, must be regularly controlled or treated with a spreader.

    5. Therapy depends on the severity

    In the following, we will explain the most important treatment options for hip dysplasia in more detail:

    1. maturation: This is suitable if the hip joint is only slightly unstable in the child or baby due to a maturing delay. In normal development In 80% of all cases, this instability is self-evident in the next two months.
    2. Wrap wide: For this purpose, a 15 cm wide folded towel between romper and diaper is inserted. The wide wrap can also be done using an extra diaper over the actual diaper. It is applied with a slight hip dysplasia in the baby and generally recommended to promote the development of the hips.
    3. Spreading: Is one Higher level hip dysplasia before, the baby can be adjusted to a spread pants or splint. These aids keep the little patient’s leg in the desired position. you will be over the Kle >

    If the baby has only a maturing delay, in most cases no therapy is required.

    Hüftgips: If after a hip dislocation the hip Once again, it has to be immobilized. this happens in severe cases with a hip plaster. This usually extends from the lower costal arch to the lower leg of the baby. But do not worry – the little patients usually get used to it quickly and get along well with it. The The duration of treatment may be several weeks or possibly several months.

  • Surgery: This may become necessary if other measures do not help with the treatment or even if the malposition was detected too late – for example, in children from three years or older and adolescents. There are different surgical procedures.
  • Hip dysplasia in child or baby can also treated with a targeted physiotherapeutic treatment become. Physiotherapy trains the tissues and muscles to promote mobility. The therapy differs greatly depending on the age of the child. There is also good experience with osteopathy. According to one study, a thorough osteopathic treatment compared to a conservative orthopedic therapy resulted in a more complete elimination of the problems.

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    Christina Cherry
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