Physiological immaturity of hip joints: etiology and pathogenesis
Physiological immaturity of the hip joint — is a common problem faced by many mothers of newborn babies. Very scary mom scary word «underdevelopment», which sounds like a death sentence. Do not be upset! This pathology is quite serious, but correctable. Timely diagnosis and corrective activities help, in most cases, to reduce the effects of underdevelopment to a minimum. In order to help the kid to recover, you need to understand the cause of problems with the joints.
What is the physiological immaturity
First of all, it should be noted that the concept of «physiologic immaturity» means that this process occurred in a number of «natural» causes and severity of pregnancy in the mother. Some physiological characteristics of hip joints in newborns occur as a result of violations of motor activity of the embryo and fetus before birth. The child’s body as a whole and its individual organs in particular can be considered Mature when their physiological functions correspond to the calendar age.
Physiological immaturity of hip joints is more common in premature babies. These infants differ from full-term not so much anthropometric data, many physiological characteristics. You need to consider that even in the normal hip joints of newborns are immature structure.
Thus, among the predisposing factors for the development of joint pathology are the following:
- genetic predisposition;
- breech presentation of the fetus;
- toxemia of pregnancy;
- the appointment during pregnancy some medicines;
- gynecological diseases pregnant;
- large fruit;
- multiple pregnancy, etc.
Underdevelopment of the hip joints in newborns often leads to various forms of dysplasia, and dislocation or subluxation of the femoral head.
The main symptoms of pathology and diagnostic methods
A preliminary diagnosis of «immaturity of hip joints» can be delivered to a baby still in the hospital. If this happens, then the parents are directed to the examination of pediatric orthopedics. Do not delay going to the doctor! The most effective is the treatment of children first year of life. The fact that ossification of the femoral head occurs at the age of 7-9 months, and in girls, this process occurs faster than boys.
The differential diagnosis is established by the podiatrist based on the inspection survey of parents and visualization methods. The most accurate diagnostic data gives the ultrasonic examination of the hip in newborns or ultrasonography. After 3 months perhaps fluoroscopic study which is also quite informative. Ultrasonic there is some classification to determine the degree of maturity of the joints (on the Graph).
According to this classification, type 2A on the Graph in premature infants and children up to the age of 3 months indicates immature dysplastic joint, and this condition requires follow-up. If a similar pattern is observed in children older than 3 months, the child needs appropriate treatment.
Clear symptoms of pathology are most pronounced in children aged 2-3 months. Some signs in children the first month of life can be considered a normal variant. Among others, decided to allocate the basic symptoms of the immaturity of hip joints:
- shortening of the thigh on the affected side;
- muscle hypotonia;
- asymmetry of skin folds;
- limitation of abduction of the joint;
- the symptom of «clicking» (or Marx-Ortolani).
An accurate diagnosis can be put only in the presence of several diagnostic features, as some of them may be false. Asymmetry of skin creases in babies first month of life, it may take 3 months to myself, femur shortening may be absent with bilateral lesion but a symptom of Marx Ortolani find half of the newborns, but by 3 months he is without any outside interference.
Correction of dysplasia in the immature hip joints
There are many methods of treatment and correction of this pathology. The most common method of conservative treatment is to hold the legs of the baby in a certain position (flexion and abduction). For this purpose, use:
- applying tire;
- orthopedic devices;
- Pavlik’s stirrups;
- special pillows;
- wide swaddling.
In the treatment of younger children need to pay attention to the following. Devices to hold limbs in the desired position should not cause discomfort to the kid and completely restrict his movements. It is very important for the well-being of the child.
Of great importance in the healing process are massage and physiotherapy. For every kid experts select the individual complex of exercises and specific massage technique, aimed at strengthening the muscles. Such procedures are carried out, usually in specialized clinics in hospitals. However podiatrist can show parents a number of exercises that they can do themselves at home.
If conservative treatment is ineffective, then make the decision on reduction of the dislocation with subsequent fixation plaster bandage. This treatment is used in children aged 2 to 5 years. After 5 years, such treatment is not possible. In severe cases, possibly surgery. In the course of the operation is performed open reduction of the dislocation.
You need to refer to specialists ‘ recommendations seriously. The consequences of untreated dysplasia can occur in children and youth and in older age. Hip dysplasia is the cause of development of dysplastic coxarthrosis of the hip joint in people aged 25-55 years.
It is important to realize that the sooner treatment is started and resolved pathological changes in the immature hip joints, the more favorable is the prognosis.