Congenital hip dysplasia

Congenital hip dysplasia

    * Introduction
    * Pathogenesis
    * Signs and symptoms
    * Diagnosis
    * Treatment
Hip dysplasia can be traumatic or congenital. Development of hip dysplasia definition is still controversial. Typically hip dysplasia is the term used for patients who are born with hip dislocations or instability, which can then lead to dysplasia Solca. A broader definition of hip dysplasia is the abnormal growth of the balance. This includes bone structures as the proximal femur and acetabulum, labrum, capsule and other soft tissues. The annual incidence of congenital hip dysplasia is 2-4 cases per 1000 births and approximately 80% of individuals affected are girls. The condition can occur at any time from conception until skeletal maturity.
Congenital hip dysplasia is the result of interruption of the normal relationship between the acetabulum and femoral head. Without a proper contact between them, none will develop normally. At birth the acetabulum is large, small bones and cartilage content and the percentage of the acetabulum Covers femoral head is smaller, so the first 6 sapatamini child's life are critical for the development of joint. The etiology of hip dysplasia is not clear, but the condition seems to be associated with a number of factors such as genetics, race, child sex, intrauterine position, oligohidramonosul, cerebral palsy, myelomeningocele, artrogripoza. Development of hip dysplasia involves abnormal growth of it. Associate ligementara laxity.
Early clinical manifestations are identified during examination of the newborn and make ortolan maneuver. Other physical signs include asymmetry late dislocations buttock or lateral skin folds, decreased abduction on the affected side, walk or bipedal position with external rotation and inequality between the legs. Unilateral dislocations cause significant inequality of the legs, the imbalance of the weight and pain of the thigh and knee. Developing false acetabulum is associated with adverse prognosis in 75% of patients. Failure to diagnose and treat hip dysplasia in the immediate neonatal period may cause significant morbidity: the need to open and develop osteoarthritis therapies. The possible complications of treatment include recurrent dysplasia, recurrent dislocations and femoral head avascular necrosis.
Indications for surgery depend on the severity of the disease, and the formation bilateralitate or not a false acetabulum. Indications for treatment depend on patient age and the success of previous techniques. Children under 6 months examination instability are treated with a form of limb tijare and harnesses. If this method has no benefit to trying to reduce the traction before closed reduction. When the child is over two years or failure to consider other methods attempted open reduction. If the patient has more than three years trying to shorten a member. One patient with residual acetabular dysplasia over four years should be treated with an acetabular procedure. Treatment for a patient diagnosed in adult age is considered for residual hip dysplasia.
Evolution of children treated for hip dysplasia is very good, especially if dysplasia is controlled by closed treatment. If successful techniques have not closed and open reduction is required, the prognosis is less favorable, although short-term prognosis seems favorable. If secondary procedures are needed to achieve reduction worsens prognosis. Early diagnosis is crucial issue of treatment of children with hip dysplasia. Using ultrasound and other imaging procedures and implementation of specific educational programs decreased the number of children with hip dysplasia and late diagnosis. Less invasive techniques: the endoscopy, imaging-guided surgery is an effort to decrease mortality from surgery and speed recovery.
Although for most patients the problem resolves spontaneously within the first months of life, persitienta dysplasia can cause chronic pain, disorders of growth and weight and degenerative arthritis. In its severe hip dysplasia is one of the most common congenital malformations and a significant cause of disability in childhood.