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Orthopedists' dream of finding a DDH from birth and seeing the blood supply to

the hip joint has come true,the treatment has become safer,

the risk of necrosis of the femoral head has vanished.

. The development of ultrasound allows to see more and more accurately the incorrect

building of even the smallest elements of the hip in a newborn.

 


Congenital Developmental Dislocation of the Hip (CDH) occurs in 1-2% of the newborns,up till now,


it is estimated, that  the same number of newborns  babies with CDH requires the hip joint


replacement as about 60 years ago ,when they were the clinical examined.

 

Adult hip dysplasia 9 times more common than infantile hip dysplasia.


Only an ultrasound examination of the hips enables a detailed diagnosis of the smallest anomaly in


the infant’s hip joint.


Only a specialized medical doctor with appropriate knowledge and experience can properly diagnose of CDH


and applied adequate treatment


Clinical tests helps to detect hip instability, which occurs only in13  per cent of newborns with CDH.


Clinical examination is also completely not harmful, it may lead to mechanical joint damage and to disturbances


in blood supply if it is performed not gently or it lasts too long.


In order to guarantee successful treatment, the CDH must be detected in the newborn Unit right


after the Birth and rebuilding of Hip instability must be completed,by 5th week of age(when


the  regeneration process is the fastest


Both methods allow for an early diagnosis and appropriate treatment, which helps to prevent:


-     a worsening  hip dislocation,


-   a risk of femur head destruction(necrosis) caused by treatment (from 0-1% if detected within


the first week of life to 60% if detection is delayed (muscular contracture occurs)), depending on the method of


treatment and when treatment begins,


-pain in the hip joint due to its destruction (osteoarthritis)  and its replacement  at a younger age and


more frequently than normally;


-expensive and risky surgery in nearly 100% of cases.


Failure to detect CDH in time or inappropriate treatment will result in complication many year later,


when it is too late for prevention


Contraction of hip muscles (until recently the only indication in the diagnosis of DDH currently of little


importance in the diagnosis according to the latest American research) occurs to a various degree


in 10 per cent of all infants,however,only a small percentage is caused by an abnormal hip joint


Early detection shortens the time of treatment  and also means less severe treatment methods.


The proposed method eliminates the need to use harmful radiological tests.


The ultrasound hip screening by a qualified doctor is a standard procedure in  countries such as


Germany,Switzerland Austria,which acheive four time better results of treatment ( at present


the best ever results in the world) than countries which do not apply obligatory


ultrasound examinations


Remember: This problem may affect any baby!


 

 

Every mother may increase the chances of proper development of her babies hip joints by


putting it in a position that enables joint surgery

The best conditions for a joint rebuilding occurs when the flexion of the femur is above


90 degree(knees the buttocks line) and abduction above 45 ( both spread thigs lying on


the basis in symmetrical position)

Nature itself makes proper development of hip joint possible through a protective


,physiological muscles contracture which enables proper limb position .Therefore bent legs of


a baby shouldn,T be straightened while nursing or dressing ,but helped to remain in this beneficial for hips

position.


The rules for treatment and prevention are similar: hip bending over 90 degrees and an abduction


of over 45 degrees. In treatment, however, we use different kinds of orthopaedic equipment.

Due to significant hip regeneration capacity in newborns, it is recommended that, for preventive reasons,


newborns should be lifted and placed with their legs wide astride and bent in the hips, and with their knees


above the buttock line, at least until they are 6 months old.


We also recommend that the newborn should be placed on the stomach under supervision


pict.1



or, even better, be placed and carried on an adult pict.2.and3





In the case of muscular contracture, direct abduction is not allowed as this may cause femur head necrosis,


if the point of support for the lever is the femur head.

 

or you can sit  infant on the lap for older or reclined for young infants


It is important to note that the newborn’s head should be placed on one side only to avoid muscular


asymmetry (MBS) due to mainly by head deformation.

 



case of Anna 6 days y.o


typ P D ; L IIIa

 

 

 

 

7 days y.o

typ P IIa L D

 

 

 

 

8 daysy.o.

Typ P IIa  (down)

L II/D (up)

 

 

 

2 months

typ P GN   L I

 

 

only preventation by parents

 

 

 

Prevention of neonantal hip joints DDH is one of the few that, if properly performed, guarantees 100% effectiveness!

If this is not , it means that someone did something wrong.

(I have examined over 300 thousand infants, I am sure of that now.)

 

 
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