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Treatment of hip joint dysplasia

Treatment of hip joint dysplasia

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Description of the disease

Hip dysplasia is a congenital luxation or subluxation of the hip, often being intrauterine. It is one of the most common congenital disorders of the musculoskeletal system. Most scientists claim that girls suffer from this disease more often than boys. The statistics show a ratio of 6:1.

The specialists of Ladisten Clinic have faced the disease in both sexes over the years of practice.

The main causes of dysplasia are as follows:

  • heredity (ethnicity);
  • sex;
  • the influence of female sex hormones, relaxin;
  • breech or foot presentation of the fetus;
  • insufficient amount of amniotic fluid.

When can dysplasia be suspected?

There are many options for how to determine dysplasia, but their accuracy is questionable:

  • Perhaps the most popular method that any mother has heard about is by the asymmetry of skin folds. Each human being is individual, therefore, the development of hypodermic tissue is not an indicator at all.
  • Different leg length. It is rarely possible to suspect dysplasia by this criterion. Few people manage to see the difference with the naked eye, because much depends on how the baby is laid.
  • Limitation of mobility of the leg. This is noticed in children older than a year, but especially vigilant grandparents may pay attention earlier. The reason may be a small diaper, an uncomfortable mattress and a number of other nuances. This method is not reliable as well.

The “gold standard” of diagnostics is considered to be X-ray examination which allows to sort things out. It must be taken in the age three months for all children without exception to diagnose the disease in time.

Ultrasound is considered a more modern method. It is often used in hospitals, but this is just a waste of money and time because the data obtained don’t show an accurate and complete picture of the pathology.

Types of Hip Dysplasia

Dysplasias themselves are distinguished by several types:

Kind Type Description
Immature joint 2a Hip preluxation is observed in case of immaturity of the joints. It is considered norm in most babies of up to 3 months. There are no serious violations, but medical suprevision is needed. Types 2b and 2c are subject to correction.
2b
2c
Subluxation 3a In case of the hip joint subluxation, the X-ray shows the displacement of femoral head up and to the side. It is still in contact with the acetabulum, but treatment is necessary.
3b
Luxation 4 The femoral head is located outside the acetabulum. Operation needed

The mature joint falls into categories 1a and 1b and does not require treatment.

In case of type 2a hip dysplasia, treatment is not carried out until 3 months of age as this is considered the norm. However, medical supervision is needed.

Coxarthrosis is visible on x-rays as a narrowing of the intra-articular gap and the appearance of bone outgrowths called osteophytes.

Full X-ray diagnostics, ultrasound and additional examinations in Ladisten are performed using modern equipment.

What is the danger of hip dysplasia?

Dysplasia is a pathology. It is a mistake to think that it does not have serious consequences. In case of this disease, the entire hip joint is incorrectly formed, and it is one of the largest and most important joints in the whole body. It provides upright position and normal gait.

In case of dysplasia, the femoral head is positioned incorrectly in relation to the acetabulum. As a result, the gait is disturbed:

  • waddling gait may occur;
  • excessive “wagging of hips” is observed, the gluteal muscles seem to be located higher;
  • if limb length discrepancy is present, lameness develops.

Cartilage tissue is formed gradually, but in case of dysplasia, this process is impaired. The pelvic bone also suffers changes. As a result, the joint loses part of its functions, which can lead to disability.

Pathology affects the entire musculoskeletal system. The load on it increases, the person constantly gets tired, muscle weakness develops.

At Ladisten, only modern equipment is used to determine the exact angle of displacement and the degree of pathology.

In nine out of ten clinical cases, patients who didn’t receive the necessary treatment in time may get several complications:

  • coxarthrosis;
  • motor disabilities of the leg;
  • cosmetic deformities;
  • neoarthrosis (formation of a new pathological joint).

Coxarthrosis, that is arthrosis of the hip joint, is especially dangerous. The disease destroys cartilage and adjacent bones. As a result of coxarthrosis, the patient cannot walk normally and experiences constant pain.

Treatment of hip dysplasia

The most important point in treatment of the disease is timely diagnostics. At Ladisten, only modern equipment is used to determine the exact angle of displacement and the degree of pathology. At the initial stages, the treatment of dysplasia is possible with help of special orthopedic constructions: Pavlik harness, Gnevkovsky device, Freyk’s pillow etc. This is done for up to twelve months. Constant wearing of constructions is an integral part of treatment. In the absence of positive results, surgery is recommended by the age of one year.

There are many articles on the Internet about the treatment of dysplasia, from the technique of wide swaddling to invasive procedures. You should remember though, that if there is a slightest suspicion of a congenital luxation you need to consult with a professional doctor immediately, without getting involved in folk medicine, as it can make the situation worse.

In case of this pathology, there is no time to lose. An experienced orthopedist will diagnose the disease accurately and properly and then will prescribe the correct treatment.

Treatment in children

In most cases, the diagnosis of hip dysplasia is made during the first year of life. This is a natural condition until 3-4 months of age, and it disappears on its own in 80% of cases. But there is always a 20% probability of pathology, so the baby is supervised by an orthopedist. Mandatory should be carried out at the age of 3 months, 6 months and one year. If the pathology is found, there is a need to visit a doctor more often. Timely measures give a positive result of treatment almost immediately.

How to treat dysplasia in children:

  • Massages, gymnastics, physiotherapy and wearing of harness are prescribed for infants. As a rule, this therapy is enough. The main role is played by time: the sooner you put on harness and do the procedures, the more favorable the outcome. Orthopedists try to do this as early as at the age of 4-6 months, until the baby begins to sit and walk. It is important not to put the baby on his or her feet during this period. Wide swaddling is what the parents can provide by themselves;
  • if the situation has not improved during the first year, the baby is constantly monitored. Conservative treatment can still be continued for several months. But this significantly holds back development of the child, because he or she should already walk by this time. A positive result can be achieved by a dislocation correction surgery or osteotomy;
  • it is difficult to treat hip dysplasia in adolescence. Conservative methods would no longer help. The only way out is surgery. In the case of developed coxarthrosis, it will be simultaneously eliminated.

If the child has suffered from dysplasia at an early age, you should continue to show him or her to the orthopedist every year. This will allow to notice abnormalities in time.

Is it possible to treat hip dysplasia with massage?

Massage plays an important role in the treatment of dysplasia, but not the leading one. The purpose of the massage is to normalize muscle tone, eliminate contractures of the adductor muscles, form a range of motion in the joint, improve trophic processes, create conditions for the femoral head to be placed in normal position.

It is impossible to fully cure dysplasia with only massage. There are several main factors that affect the result:

  1. Age of the patient. It is possible to treat dysplasia in babies aged 3 months to one year with help of massage. But it must be carried out together with gymnastics. At an older age, massage does not help.
  2. The degree of dysplasia. In case of 2b and 2c types of dysplasia, as well as congenital hip luxation, massage is not the main treatment. But it can be used in combination with physiotherapy, harness and splints. If the patient has undergone surgery, then massage is necessary at the recovery stage. It speeds up this process significantly.

You should keep in mind an important point! While doing massage, you not only make movements but feel the anatomical location of all structures, feel the joint, calculate the pressure and angle of rotation. Is it possible for a person without special qualification to do this? Therefore, using the method of massage on your own is not a good decision. An incorrectly performed procedure can only do harm.

Surgical treatment of dysplasia

The need of surgery in case of hip dysplasia makes parents worried. It is necessary to realize the importance of treatment and the consequences that a grown-up child will face if it is absent. The operation for hip dysplasia at Ladisten Clinic belongs to the category of minimally invasive procedures. Its duration is 30 minutes.

Low invasiveness and blood loss contribute to rapid recovery. Any large scars that may be a reason of discomfort or embarrassment in the future, won’t remain on the child’s body.

To make an appointment, you can call the numbers:

 +38 (044) 209 80 54
 +38 (067) 794 46 86
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We will help to choose a convenient time for you to give us a visit or hold an online consultation during which we will examine your problem and answer all questions.

In 30 years of work of Ladisten Clinic, we have already helped more than 6,000 patients from 36 countries!

Doctors

Founder/Chief surgeon

Veklich Vitaliy Viktorovich

The founder of “Ladisten” medical center of orthopedics and traumatology Veklich Vitaliy Viktorovich is a surgeon in the field of orthopedics and traumatology for children and adults who has been practicing for more than 35 years. Author of the modified external fixation devices – the Veklich devices.

Work experience: 40 years
Head doctor, orthopedic and traumatic surgeon

Veklich Viktoria

Head doctor of the Ladisten Clinic Medical Center, a professional certified surgeon in the field of pediatric and adult orthopedics and traumatology.

Work experience: 6 years
Anesthesiologist

Oleg Medvedev

Doctor of Medicine, anesthesiologist

Work experience: 27 years

PREPARATION

After receiving the results of diagnostic tests, the doctor chooses a treatment plan and gives a consultation. He answers the questions of the patient (or his/her parents, if the treatment is carried out for the child), voices the price, tells about the predicted results and possible complications, agrees on the date of the surgical procedure.

It is advisable to arrive at the medical center 2-3 days before the appointed date of the operation, which would allow the patient to take all needed tests, prepare psychologically, and consult with the anesthesiologist. The operation itself lasts for 30 minutes.

REHABILITATION

The rehabilitation is carried out by using the Veklich fixation device. The experts determine the size and shape of the construction individually, depending on the anatomy of the child’s legs and the exact diagnosis. In total, the time for the device to be worn and the entire recovery period last about two months and depend on the individual characteristics of the body and severity of the pathology.