Time to rethink the use of hip spica cast and traction over head (popular in Europe: the benefits remain controversial.) or anesthesia to stretch the contracted muscles
due to displacement of the femoral head in Ddh.Caused by non-elevated muscle tension or permanent damage to the muscular nervous system,these changes are short-lived
and last a few months due to mechanical displacement.
Rehabilitators dealing with infants with muscle contractures in PCI easily remove them .. If 3 x 20 minutes every other day is enough to remove muscle contracture in
infants, the more strains can also be removed, they only require more work.
The head of the femur lies superficially and is accessible for rehabilitation as well as the surrounding muscles.
The use of multiple days without breaks in the procedure causes only blood circulation disorders and necrosis (avn).Patient and tedious rehabilitation with a non-
cooperating infant is enough to improve. Muscle cramps recur as the child grows, so the exercises need to be repeated from time to time.
The problem is that ligamentum is stronger than the bone in this age and it is easier to damage the bones and the easiest way to disturb the blood supply is that
the vessels close before the end of the maximum muscle tone, the main artery which scrolls around the m . lipsoas. the stretching it is the most problematic because there
is no access to it almost completely because it is inside the body.
case Natalii typ IV right hip diagnosis 1month; tratment with orthesis wthout effect to 5 month
rehabilitation was ordered ;
slowy increase from 3 time a week to 3 time a day ( 20 minutes each time)
type IIb but unfortunataly unstable becouse with overgrown lig. capitis fem. (big white echo on the right and below side of the femur's head )
