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
90degree (knees the buttocks line) and abduction above 45 ( both spread thigs lying on the basis
insymmetrical 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,To 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 abductionof 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
21 days
28 days
2 months
typ P GN L I
only preventation by eltern
case Barbara 6m. y.o
8m y.o
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.)
1in10
infants are born with hip instability.
1in100
infants are treated for hip dysplasia.
1in500
infants are born with completely dislocated hips.
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.