Hip dysplasia (DHH) Developmental hip dysplasia, also known as congenital hip dislocation, is the most common hip disease in children. Risk factors for the development of DDH include: baby girl, breech delivery, joint laxity, family history, first child, and other medical history. DDH is not easy to find in the early stage, and the asymmetry of the hip striae is one of the early signs of DDH, and in the later stage, there may be limited hip abduction, asymmetrical skin striae of the femur, unequal length of the lower limbs, and lameness. If the best time for conservative treatment is missed, even surgery in the later stage cannot restore the walking function of normal people, resulting in lifelong limb disability.
What is leg asymmetry?
The leg lines are asymmetrical, and many parents find that the lines on the baby's legs are different when bathing or changing diapers.
In addition to the asymmetry of the leg stripes, it is more common to have the asymmetry of the buttocks, which can be observed that the size of the two sides of the baby's ass is different.
But whenever such a problem occurs, parents begin to brain supplement various serious consequences, is it hip dysplasia? What should I do if there is radiation in the X-ray? Is it necessary to have surgery after diagnosis?
The asymmetry of leg lines and hip circumference is a sign of early detection of hip dysplasia in parents. This is also the reason why parents are starting to worry.
However, there is another reason, which is that the baby is fat, which is also the most common reason.
Why does my baby have hip dysplasia?
Hip dysplasia is one of the more common congenital malformations in infancy and childhood, and the main cause of this deformity is heredity, followed by the environment inside the mother's uterus. Improper care after birth (like a candle pack) can also affect hip development, and severe ones can cause hip dislocation.
The disease is difficult to detect before a child starts walking, and parents can only judge by the asymmetry of leg and hip lines. However, when bilateral hip joints are underdeveloped, thigh stripes may be normal.
Toddlers, because one leg is shorter than the other, the stability of the affected leg and the hip muscles are not as strong as the healthy side of the leg, so the baby with the disease is prone to obvious lameness.
The sooner the disease is detected and treated, the better your baby's prognosis. Therefore, it is very important to do a good child care physical examination.
Leg/hip streak asymmetry≠ hip dysplasia, how to self-examine?
As we said above, asymmetry between baby leg and hip lines is not necessarily hip dysplasia. If parents find that their children's bilateral leg stripes or hip tattoos are asymmetrical, they don't need to be too anxious, they can simply check themselves at home first.
During the examination, the baby is lying on his back, straightening and bringing his legs together to see if both lower limbs are equally long. Isometric length is normal; unequal length of both lower extremities indicates a possible unilateral hip dislocation.
Lying flat on the hips and bent knees on the bed, if the knees are equal in height is normal. In single hip dislocation, both knees are not equally high and low.
The child's legs are abducted, under normal circumstances, the legs can be turned outward by 80 degrees, the hip joint is abnormally developed, and the legs can only be turned outward by 40 to 50 degrees.
If none of these checks are problematic, then there is no need to worry. If there is an abnormality, it is recommended to take your child to the hospital to see a doctor.
Outreach tests
Let the baby lie flat on the knees, and the doctor holds his knees, with his thumb on the inside of the knee and the remaining four fingers on the outside of the knee. Normal children may have abduction of 80° to 90°; if the abduction is less than 70°, it is positive, indicating a possible hip dislocation.
Ortolani sign
For babies with hip dislocation, this test is used to determine the degree of instability of the hip joint, also to make the child lie flat and bend the knee, the doctor holds the child's knee, initially performs a slight internal rotation, and then gently lifts the large trochanter and slowly abducts the thigh, if the hip can be reduced, there will be a significant sense of reduction.
Allis sign
Let the baby lie flat, bend the hips and bend the knees, put the feet parallel to the bed, compare the height of the two knees, if the height is not equal, it is positive, indicating that the baby has signs of hip dislocation.
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Auxiliary examination: It is not enough to judge the baby's condition only through physical examination, we also need to pass some auxiliary examinations to clarify whether there is a problem with the baby.
B-ultrasound examination
For babies under 6 months of age, hip ultrasound is the most common and effective test. It is more sensitive to the position of the hip joint, the development of the acetabular and the instability of the hip joint, and is more accurate than X-ray examination.
X-ray examination
For babies over 6 months old, because the ossification center of the femoral head has appeared, it is no longer possible to do ultrasound, then X-ray examination is needed to play a role. X-rays show that the hip joints on both sides are asymmetrically developed, and it is necessary to go to a professional pediatric orthopedic department to treat the baby for further treatment.
How should B-ultrasound and X-ray be chosen? Which is less harmful?
Children within 6 months of age can have B ultrasound, and X-rays are needed after 6 months of age. An occasional check will not affect your baby and there is no need to worry about radiation.
Remember: usually do more hip abduction exercises for children, frog hugging, etc. are conducive to the development of children's hip joints, do not give children "candle packs"
There are several disadvantages to using a walker:
■ Due to the influence of force, it can lead to O-shaped legs, X-shaped legs, and even flat feet in infants and young children;
■ Because the cushions tend to be higher, babies using walkers often need to tiptoe to get the floor, causing tiptoeing in the long run, and this habit can even continue into adulthood;
■ The age of the walker is too young, and the baby has not undergone enough training such as standing alone and crawling, and directly begins to learn to walk, violating the normal children's motor development law;
■ The walker has safety hazards, because the walker can move quickly with a light pedal, it is easy to cause injury, and there are reports that children fall off the steps in the walker, resulting in brain injury;
■ The walker fixes the baby in the car, and as soon as the person moves, the car moves with it, which is not conducive to training the balance ability of infants and young children, the coordination ability of hands and feet and the body, and the formation of danger awareness;
■ Crawling is the only "four-legged" walking stage in a person's life, studies have shown that crawling is conducive to cultivating people's proprioception, using a walker to let children walk as soon as possible, and skipping this stage of crawling is not conducive to the formation of proprioceptive sensation.
In fact, there should be a growth process, experiencing looking up, turning over, sitting alone, rolling, climbing is a certain law, and the learning of each action is conducive to growth and development and musculoskeletal maturity. If the head is conducive to the formation of physiological curvature of the cervical spine, sitting alone and walking is conducive to the formation of physiological curvature of the thoracic and lumbar vertebrae. Each movement is the result of the coordination of nerves, bones, muscles, vision and brain balance, and learning each movement step by step is conducive to the growth and development of infants and young children.