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Fulcrum (dysplasia of the hip joint)

Fulcrum (dysplasia of the hip joint)

In dysplasia, the hip joint is formed incorrectly. The dimensions of the articular fossa (acetabulum) are less than normal, so the head of the thigh does not fit into it.

Weak ligaments and a joint capsule consisting of soft connective tissues cannot hold the head in the acetabulum, and it slips off easily. This condition is called pre-expiration.

If you do not start treatment in time, the subluxation will develop: the head of the thigh will partially come out of the fossa and move up slightly. The next stage will be dislocated.

In this case, the head of the thigh will leave the borders of the vein cavity.

The characteristic click, which is felt when the joint is moving in the pre-dislocation state, sometimes makes it possible to suspect dysplasia even in the maternity hospital. Then, as a prevention, doctors will recommend a wide swaddle. One flannel diaper 15–20 cm wide is folded in 6–8 layers and laid between the child’s legs like a diaper, the other is fixed on the legs and hips.

After a routine examination by an orthopedic surgeon at 1 month, the diagnosis is confirmed by ultrasound and x-rays and transferred to treatment.

The main method for the correction of dysplasia is Pavlik’s stirrups. They allow you to fix the head of the hip joint and prevent its displacement. Stirrups are loose, padded shoulder straps made from flannel fabric.

They are worn on the shoulders and hips of the child, thereby pulling the legs up to the frog position. Stirrups are worn without removing from 3 to 6 months. Additionally, the doctor prescribes therapeutic gymnastics.

It is performed in stirrups separately for each leg. If this measure does not help, functional plaster bandages are applied to the child’s feet for a more rigid fixation of the joint.

Up to 20% of dislocations are treated surgically, but only if other methods of correction did not produce an effect. Sometimes after treatment, special tires are used to improve the position of the head of the hip joint.

They are attached to the feet of the baby, and with their support, he makes his first steps.

In order to recognize and prevent the development of dysplasia in infants in a timely manner, it is important to know about several factors that increase the likelihood of the disease.

Most often, abnormal development of the joint occurs in pelvic presentation of the fetus. The walls of the uterus squeeze the femoral head, and it occupies the wrong position relative to the acetabulum.

Tight swaddling has a similar effect, therefore in the presence of hereditary disposition it is better to leave the baby’s feet free. Boys dysplasia develops less frequently: in the female body during pregnancy, special hormones are produced, softening the ligaments in the run-up to childbirth.

They act in the same way on the soft tissues of the girl’s joints, so favorable conditions arise for the development of pre-dislocation.

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