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Principles of prevention in DDH PDF Print E-mail
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The parents are the best orthopedic decvice  For their children in DDh


Orthopedists' dream of finding a defect 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 decreased. The development of ultrasound allows to see more and more accurately the incorrect construction of even the smallest elements of the hip in a newborn.

 

Principles of prevention in DDH

More recent specialist literature considers screening of neonates as early as possible to be ideal [1,3,7, 11, 12].
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(5)
One week of treatment after the birth equals one month of treatment later and there are no complications (1)


What should every Mother know to prevent abnormal hip development in a baby.

The most important thing in preventive examination is to find the babies with the most severe deformity and to start treatment immediately .Each day of delayed treatment worsens the deformity and a seemingly short period of 2 weeksof delayehances of some babies for a complete recovery and for avoiding surgery and femur necrosis.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  the clinical examin

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


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

typ P D ; L IIIa

 

 

 

 

7 days

 

 

 

 

8 days

 

 

10 days

 

 

 

15 days

 

 

 

28 days

 

 

 

 

 

35 days

 

 

 

5 weeks

 

 

 

 

 

 

 

 

 

 

 

 

2 months

typ P GN   L I

 

 

only preventation by parents

 

 

case Barbara 6m. y.o

 

 

8m y.o

 

 

 

only preventation by parents

 

Clinical examination statisyic: compare to ultrasound screening

 

1in10

infants are born with hip instability

(1 in 14  with DDH)

1in100

infants are treated for hip dysplasia.

( 1 in 1 000 are treated  )

1in500

infants are born with completely dislocated hips.

( in ultrasond examination newborn  1 in 50 000  )

1in10

total hip replacements is because of hip dysplasia.

9x

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

(avn?:no ultrasound screenning? my opinion)

<50years

The most common cause of hip

the International Hip Dysplasia Institute.

 
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