Leg splint for newborns

Belousov Evgeniy Ivanovich Doctor of the highest qualification category Main specialty: orthopedic traumatologist 30 years of experience

Hip dysplasia in children

Hip dysplasia is currently diagnosed in three out of every thousand infants. It is also very commonly diagnosed in children under the age of one, with a fivefold incidence in girls.

The disease has three stages of severity The hip joint is not fully developed:

• First: subluxation (the femoral head is not displaced in relation to the acetabulum; this stage, as a rule, is characteristic of premature babies or children with low birth weight, the disorder in this case is transient);
• Second: subluxation (the femoral head is partially displaced);
• Third: dislocation (complete displacement of the femoral head). Source:
  AV Sertakova
  Current knowledge on the mechanisms of hip dysplasia in children (overview)
  // Saratov Scientific Medical Journal, 2011, vol.7, no.3, pp.704-710

The hardest form is congenital dislocationin the:

• the joint capsule and the musculoskeletal system are altered;
• The joint structure is extremely irregular;
• The head of the femur is outside of the socket.

If this condition is not diagnosed and treated early, by the age of 2-3 years the child will develop severe inflammation, the dislocation will worsen, and the limp and persistent pain will persist for life.

Important!!! Early diagnosis of the disease is the key to a speedy recovery. If dysplasia is detected and properly treated in the first 6 months of life, then within a year it will disappear without a trace. If the disease is diagnosed between the 7th and 12th month of life, the treatment can last up to several years. It is most dangerous when the dysplasia is 'overlooked' and only after a year, when the child starts to walk, drastic measures are taken. In this case, there is a good chance that your child will have hip problems for the rest of his life.

Causes of anomalies

• Inherited predisposition
• Impact of the hormonal background of the expectant mother on the fetus during pregnancy;
• low amount of amniotic fluid;
• fetal breech presentation;
• abnormalities in the formation of fetal tissues;
• high fetal weight;
• certain gynecological abnormalities in the expectant mother, which limit the movement of the fetus in the uterus;
• very low birth weight (up to 2.5 kg). Source:
  MS Kamenskih, VD Sharpar, NS Strelkov, AV Islentev
  Integrated assessment of risk factors contributing to hip dysplasia
  // Genius of Orthopedics, 2012, № 4, pp.58-61.

Let's look at the top three causes among all the above.

Inherited predisposition

If a parent had dysplasia as a child, there is a 25 percent chance that their child will also have it.

Abnormal tissue formation in the fetus

The 'embryo' of the hip joint forms in the fetus as early as the sixth week of pregnancy. From the tenth week, movement in it is possible. Therefore, it is important for pregnant women at this stage to avoid all harmful factors that could affect the normal development of the fetus:

• radioactive irradiation of any intensity;
• exposure to chemical substances, including some aggressive drugs;
• Viral diseases during the first trimester of pregnancy (this is the most important factor!);
• bad environmental conditions.

Effects of endocrine disorders in the expectant mother on the fetus

When a pregnant woman has high levels of progesterone in the body, which is necessary for a smooth birth (it loosens ligaments, cartilage and joints), this hormone enters the bloodstream of the fetus as it easily crosses the placenta. This also causes softening and loosening of the ligaments in the unborn child. The negative effect of progesterone is particularly strong when the birth is breech or when the fetus is in an abnormal position during pregnancy.

Hip joints of the newborn: normal and abnormal

Before talking about the Frekeh pillow and the specifics of its application, let's say a few words about the pathology for which it was invented.

What is considered normal development of the hip joint?

Normally, the head of the femur encloses the socket and does not protrude beyond it. This is also characteristic of a newborn. However, his hip joints are not even mature enough: the socket is flatter and more vertical than in an adult, and the ligaments are flexible due to their elasticity.

hip dysplasia

Hip dysplasia, or hip dislocation, is a congenital malformation of the hip joint (often one, rarely both) caused by abnormal development of the hip joint, which may (or has) resulted in subluxation or dislocation of the femoral head.

Dysplasia means not only the dislocation itself, but also the predislocation and subluxation of the femur, that is, the various degrees of this pathology.

1. Grade 1 dysplasia is a predislocation: There is an irregular shape of the acetabular cup and/or femoral head and neck, but the femoral head is trapped within the acetabular cup and there is no dislocation.
2. Subluxation grade 2: In addition to the irregular shape of the socket and/or the femoral head and neck, the femoral head is displaced externally.
3. Grade 3 – Dislocation: The articular surfaces are irregularly shaped and separated from each other - the femoral head falls out of the socket and moves laterally and upwards.

Only the doctor can determine whether such a pathology is present or not. Newborns are examined in the maternity ward, sometimes X-rays are also taken. If dysplasia is detected, immediate treatment is indicated.

treatment of dysplasia

Treatment of hip dysplasia in a newborn is strictly individual, taking into account the severity of the disease, the child's age and other characteristics.

Features of the device.

How to choose a free cushion

The correct size of the free cushion can only be selected by a pediatric orthopedic surgeon, who takes into account the following factors, among others, when making the selection:

• The degree of dysplasia;
• the child's health status, including a history of chronic diseases;
• the age of the child;
• the maximum distance between the extended knee joints.

The orthopedist also determines how long the child must wear the device. He or she will also monitor changes in the shape of the joint.

Do not choose the device yourself: if the pad is too small, the treatment will have little or no effect; if it is too large, the child's legs will spread too far, causing pain and discomfort.

How is the pillow adjusted?

The treating orthopedist should be able to show the parents how to put the pillow on and attach it to the child's body and how to remove it. Legs should be kept in a physiological position so that the child does not feel any discomfort. Don't be disappointed if you forget the exact procedure when you get home from the doctor - instructions for use are included in all pillow packs.

There are general recommendations for use.

• To avoid sweating and skin abrasions, the Free Pillow should not be worn over a diaper, but only over cotton underwear.
• The pillow should only be carried unfolded - this ensures that the roll lies symmetrically between the thighs.
• The straps must not be too tight so as not to pinch or pinch the baby's skin - the pillow must be snug, but everything in moderation.

Don't despair if you're giving your baby a freck pad for the first time and everything fits, but your baby complains - first check that the legs aren't too wide apart. Maybe you should narrow the distance a bit. Babies get used to a correctly placed Freykeh pillow quite quickly.

Are there any disadvantages?

There is only one downside to using sleeping bags for newborns: the short lifespan, up to a maximum of 6 months. Once the baby learns to roll over on their own, using the device can become dangerous.

There are different types of changing tables depending on parents preference and budget. Let's take a look at the main ones.

1 Classic. Two triangular cushions connected by a piece of fabric. The large pillow supports the child's back, while the small pillow restricts the child's movements.

Disadvantage: Suitable for babies up to 4 months as the distance between the pillows is not adjustable.

2 rolls. Two cylindrical rollers that are connected to each other. This product protects the child from falls. The distance between the bolsters can be increased as the child grows. This type of bed is ideal for strollers.

3. Ergonomic cocoon. A modern model based on the physiological posture of the child. The child can be secured in this lying position with the help of elastic straps. This item can completely replace the cot up to 4-5 months old.

4. Mattress. In the center of the model is an orthopedic mattress surrounded by bolsters at the bottom and sides. There is an orthopedic pillow on top. This positioning aid is used up to the age of 6 months.

5. clip-on model .. This is a lounger mattress with a secure closure that holds the baby in place while sleeping or awake. This is the position in which babies are placed in maternity hospitals.

How to choose

When buying a newborn sleeping bag, it is important to look for the following features:

• the quality of the material (the positioner should always be made of natural, hypoallergenic fabrics);
• removable cover (makes the care of the article easier);
• hypoallergenic filling;
• hydrophobic layer the positioner (increases durability);
• Size (better grow into them).

Ideally, the retailer issues a certificate of the quality and safety of the product.

Advice for parents.

If your child has been diagnosed with hip dysplasia, it's important not to panic but to brace yourself for a difficult time. Children with Freudian braces, braces and insoles may sleep less well and become more capricious about being held, and of course parents have a legitimate desire to get rid of the orthopedic constructions as soon as possible. This should not be done categorically, because stability is quickly formed in children, but also quickly lost again, which is why it is so important to comply with the period specified by the orthopedist.

Regular visits to the orthopedist should not be missed, since the early detection of diseases in general and hip dysplasia in particular is the key to the child's future health.
The recommendation to swaddle babies wide should not be neglected. This way of carrying is not uncomfortable for the child and is a guaranteed preventive measure against serious joint diseases.

Things like a child's restricted hip mobility or asymmetrical leg bends should not be underestimated. Even if the doctor says that everything is normal, but the heart of the parents is troubled, in this case it is better to consult another specialist and take additional tests than to calm down and find out a definite problem in which there is is very difficult and sometimes impossible to fix.

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The information on this website should not be used for self-diagnosis and treatment.

Episiotomy/bandages for children (Freika)

Perineum Freik is recommended for children suffering from congenital hip dislocation or dysplasia. It is an effective and safe way to treat foot problems in newborns. It is prescribed by an orthopedic surgeon after consultation and examination, so choosing the product yourself is not recommended.

It is a special orthopedic device prescribed for newborns and children up to 1 year old. The indication for use is dysplasia. If used correctly, the problem can be solved. It is used for the correct development of the acetabulum and does not restrict movement in any way. When carried, the child can crawl/sit freely with legs 90 degrees apart.

One in eight young children, mostly girls, suffers from this disorder. Delaying treatment or not paying enough attention to the problem can have negative consequences in the future, including the development of lameness. The pediatrician can determine the dysplasia and prescribe a soft pillow for correction.

The child must lie on the pillow practically 24 hours a day during the treatment and the recommended duration of use is 12 to 24 hours.

The skin does not sweat thanks to the elastic polyurethane covered with a natural fabric cover that allows air to pass and wicks away moisture.

The structure is a soft roll that keeps baby's feet in a stretched position. Typically, the pad has straps that act like a jumpsuit and help keep the device securely attached to the baby. It is important to choose the right size, which varies depending on height and other parameters, so it is advisable to consult a professional before buying.

Backpack – sit high and look far away

Do you remember the Maschenka in the cookie jar that the unfortunate teddy bear took home to his grandparents? A backpack looks a lot like this box. It usually consists of a metal frame and weighs around two kilograms.

The only valuable cargo in this backpack will be your child. This design is suitable for babies from six months. Sometimes these carriers are equipped with wheels, just like a suitcase, and with an overhead tent. However, the wheels are rarely used and they add a lot of weight. A shoulder backpack is useful for long hikes. To distribute the load more evenly, these backpacks have a padded hip belt and straps at chest height that hold the shoulder straps together.

Adapted from 'Liza. My child'

Attention parents: 4 'No' for a child with dysplasia

1. Do not seek unconventional treatments, ie do not rely on bone surgeons. Because dysplasia is an incomplete joint, it is important to realize that 'translating' an incomplete femoral head into an incomplete acetabular cup is like trying to put two pieces together by completely different designers. It may work for the first few seconds, but the design will fall apart very quickly.
2. Stirrups, pads or splints should not be removed prematurely without the consent of the attending physician, in order not to reverse the healing process.
3. With hip dysplasia in children, you should not do the massage yourself, but be guided by videos on the Internet. Such manipulations should be entrusted only to a specialist.
4. A child treated for a childhood hip dislocation is not recommended to engage in rhythmic gymnastics or figure skating in the future. Sports like swimming or cycling are good for his health.

Most importantly, don't ignore the problem or hope that it will go away on its own. The sooner you see a specialist and start treatment, the sooner you can forget about hip dysplasia.

All information contained in this blog is for information purposes only and does not replace a direct discussion with your doctor!

Sources:

1. https://orthoinfo.aaos.org/en/diseases-conditions/developmental-dislocation-dysplasia-of-the-hip-ddh/
2. https://www.webmd.com/children/what-is-hip-dysplasia
3. https://hipdysplasia.org/developmental-dysplasia-of-the-hip/causes-of-ddh/
4. https://www.breastfeeding.asn.au/bf-info/hip-dysplasia
5. https://sportmedical.net/health-family/zdorove-rebenka/displaziya-tazobedrennogo-sustava

Symptoms of joint dysplasia in infants

This condition does not usually cause pain in newborns, so symptoms can only be assessed from the outside. The first consultation of an orthopedist takes place already in the maternity ward, so in most cases hip dysplasia in the newborn is diagnosed at an early stage. Statistically, 80 percent of cases occur in girls. Parents should alert the doctor to the problem if they notice the following symptoms

• One of the baby's legs is shorter than the other when kneeling;
• additional skin folds in the buttocks and groin, especially with unilateral dysplasia;
• inability to fully straighten the baby's hips — they usually rotate 90 degrees, but with joint dysplasia, this angle is reduced by almost half;
• Signs of slipping – when stretching the legs, the joint head is displaced from its axis.

Dysplasia can be detected both at the first examination after birth and before the age of 12 months. If it is discovered later, it tends to be neglected and is associated with numerous complications.

causes

The disease arises during the development of the fetus, and therefore directly depends on the health of the mother. The main causes are metabolic and endocrine disorders. The insufficient supply of the fetus with essential elements leads to pathologies of various systems and tissues. This includes dysplasia. The causes of their occurrence are:

• heredity;
• abnormal or late pregnancy
• difficult birth;
• excessive weight of the fetus;
• breech or lateral position in the womb;
• maternal obesity.

Hip dysplasia in newborns can also result from careless behavior during pregnancy. Excessive exercise, an unhealthy diet, smoking and alcohol consumption have a negative impact on the future health of the child. Consuming poor-quality food and water and living in a polluting environment also increase the risk of contracting the disease.

Which doctor should I take my child to?

The earlier the disease is detected, the greater the chance of successful treatment. Therapy is most effective in children younger than six months. Joint dysplasia in an infant can be detected at one of the mandatory preventive medical examinations. The doctor will determine what the disease is:

diagnosis and treatment

The multidisciplinary children's center 'Edkarik' in Kaliningrad has a whole arsenal of modern treatment methods for diseases of the musculoskeletal system in young children.

During the initial examination, a qualified specialist assesses the child's condition and collects family history. To confirm the diagnosis will be given to the little patient the following procedures are prescribed to the little patient:

Based on the findings, the pediatric orthopedist makes a diagnosis and selects the best treatment regimen for the child.

With dysplasia in children, conservative methods using orthopedic devices such as splints, pillows and tight diapers are often used.

Massages and physiotherapy are a must in the treatment package. Physiotherapeutic treatments are very effective in these cases: sea salt baths, paraffin applications.

Surgical methods are used only when the joint is severely underdeveloped.

It remains to be added that the positive outcome of the treatment depends entirely on the parents. Don't ignore even the smallest signs of trouble. It is better to be on the safe side than to suffer the consequences of your own inattention.

You can make an appointment by phone with our experienced orthopedist and traumatologist. Don't put off until tomorrow what needs to be done today!

'EDKARIK' IN PICTURES

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• Legs of different lengths in a child.
• The child has a shorter leg than the other.
• How do you know which leg is pushing?.
• shortening of the hip.
• What the orthopedist pays attention to.
• The baby has short legs.
• baby splashing.
• A child begins to have clubfoot between the ages of 1 and 5.