Treatment of hip dysplasia without stirrups and operations
- What does it mean?
- Symptoms and consequences
- Treatment of hips joint dysplasia
- A case from practice
- The principle of treatment
“City” TV. Modern methods of hips joint dysplasia treatment of kids. Interview.
Ignatyev Gennadiy Vasilievich : “ My first patients, who have diagnosis “Hips joint dysplasia” were my 5 children. Now they have their own children. The oldest daughter had been diagnosed 28 years ago. Doctor prescribed to wear stirrups. Even yet I didn’t agree with the fact that this is the only way of treatment. This is stimulating me search alternative way of treatment. And when, I develop a method of treatment for nursling. Now I can confidently tell you what there such way is. It will be right to call this methodic prophylaxis, what every baby needs. If you have preventive treatment after born, help to get rid of many concomitant diseases, when scoliosis and osteochondrosis appeared in adult age. Many parents think, what scoliosis inevitable, I can confidently say, that my children and patients, who were treated in childhood, now growing healthy beautiful and hardy. But every person has a right to choose method his own treatment. “
What is hips joint dysplasia of children?
Hips joint dysplasia – it is frequent pathology of the musculoskeletal system of newborns and infants. It is characterized underdevelopment, offsets, not centering and the asymmetry of hips joint elements as acetabulum, the femoral head to the surrounding muscles, ligament and capsule.
There are 3 types of hips joint dysplasia:
3. Dislocation of the hip
- Semiluxation and subluxation can have every second or third child. It can be one-way and two-way and proceeds practically painless in childhood. Child can walk free, run and jumping and parents can’t notice any deviations, except clubfoot, strephexopodia and scoliotic posture. If it is semiluxation, femoral head can move freely inside the joint, thus ligaments surrounding the joint are weakened, and then formed instability.
- Subluxation — femoral head may jump out and return to their place in the joint. During this process you can hear deaf click.
- Dislocation – it is very rare phenomenon. One child from 1000 children can have such pathology. When dislocation happens, femoral head is out of joint.
Causes of hips joint dysplasia:
1. Breech presentation of fetus. (Legs are bent in the hips and unfolded in the knees, feet are at shoulders. It is the frequent cause of Cesarean).
2. In utero cord entanglement.
3. Confinement and postnatal traumas.
4. Mother’s gynecological diseases, that can obstruct movement of the child in untero.
5. Genetic predisposition, if relatives have such pathology.
6. Hormonal disorders in women during pregnancy
7. Premature babies
8. The impact of external environmental factors
Whence undertakes disease dysplasia?
In this case, we can’t tell you all without terminology. Let’s describe one of the ways origins of children’s dysplasia. When it is happens a functional block in the cervical spine (what occurs during and after the childbirth) the upper trapezius share tightens. In the same time, there is the tension in the lower lobe, subsequently in the thoracic spine is blocked in the lumbosacral and sacroiliac joints. As a result, on the one side the iliac crest rises above, misalignment of the pelvis happens (twisted pelvis). Can we talk about stirrups, when on the one side the leg looks shorter than other? Accordingly, the femoral head disposed asymmetrically towards to another. Any dynamic loads are painful in this case. And any massage, any orthopedic appliances can’t correct this. You lose every hour, every day, every week, and every month. But also remember about the displacement of the cervical (read about torticollis) which leads to disruption of cerebral circulation. Don’t forget about hypothalamus which regulates the production of hormones by other glands, including hormone productions, that responsible for normal growth and healthy.
As you can see, treatment should to be complex. Due to the use manual methods of diagnostic and therapy, we can successfully correct many problems.
The symptoms of underdevelopment joints of children
What should put on parent’s guard?
Until 1 year. There are: Increased tone of the muscles of the back, visually one leg shorter than another, one more tuck on the buttock, asymmetry of the gluteal folds and buttocks, incomplete breeding legs with bent knees. The child has C-shaped, put his head on the one side, child frequently on one hand keeps compressed cam.
3-4 months. You frequently can hear a click, by bending the legs at the knee and hip joints, planovalgus deformity, heel is not in line with the lower leg, One leg visually shorter than another.
6 month and older. The child has a habit to stand up and walk on fingers, fingers of one or two legs during the walk turned inward or outward, clubfoot; excessive curvature of the spine in the lumbar, horizontal pelvis, walk “like a duck”; Visual light curvature of the spine, stooping; one leg are shorter than another because of sloping basin.
Treatment of infant’s dysplasia
Traditional treatment of hips joint dysplasia
Even orthopedists, traumatologists and surgeons haven’t the same opinion how treat dysplasia. Dysplasia is manifested with all children in different ways and not always can be defined after birth. Joints may be «normal» after birth and after first month of development. But then it can be diagnosed as abnormal, pathological to 6 – 12 month.
During the primary survey, at once after birth, even very experienced orthopedic can’t give a precise diagnosis. But propensity to hips joint dysplasia can be predict from the first day. If put your attention on torticollis (the child always keeps his head in one side).
Every child is unique and develops according genetic characteristics of parents. Parents used to think, that his child haven’t teeth at 7-8 month and for example, his prefontanel are not “close”. Parents sure what teeth will grow and prefontanel will close, although these two states may be compared with the «oral dysplasia» and «dysplasia skull».
But symptoms of hips joint dysplasia, should be monitored, because in fact children’s dysplasia it is weak, incomplete development of joint, generally it is natural feature of child’s organism and much less it can be a symptom of true dislocation.
Since last 30-40 years nothing were change in the treatment of hips joint dysplasia, except various orthopedic appliances and test them on children. Pavlik stirrups, Frejka’s tire , CITO, Rosen’s, Volkova’s, Shneyderova’s , Gnevkovskiy’s apparatus, etc. - all these orthotics are necessary only for the true hip dislocation. But it prescribes almost for every child from 1 moth to 1 year old, for the constant wear, except bathing. As a result, there are disturbances in the child’s mind. At first time he whiny, restless, and then depressed, depressed, withdrawn and apathetic. I repeatedly saw children in this apparatus in the age of 2, 5 years old; they differ greatly in physical and mental development. But there were also children, that adapted and jumping, running with their peers.
Modern treatment of children’s dysplasia with the help of methods of manual therapy
If you are going to a doctor, you should bring: copies of discharge from the hospital, findings and conclusions of orthopedic, x-ray or ultrasound picture and copy with its description.
Let’s us recognize, that the traditional treatment of dysplasia sometimes like a torture for children. If you want to understand diagnose the root cause of the disease, dislocation, subluxation does not use orthopedic appliances. Every day child should to explore the world, to experience the dynamic loads on the hips joints, that improves blood circulation and restored all functions; there is a normal physiological development of the hips joints and the tissues surrounding it.
If you look at this problem only in way of orthopedics, considering only the breach in the hip joints, you should not forget about integrity of the organism as a single functional system.
A lot of specialists of narrow profile are very critical approach to innovation treatment, especially to manual therapy. I was pleasantly surprised, being at the International Conference on manual therapy at 2002. I found that I am not the one, who doesn’t like the old methods of dysplasia treatment. There are orthopedists that learn techniques of manual therapy. Unfortunately, in Ukraine it is possible only in future.
Attention! If the layman tries to use manual therapy, it can cause irreparable harm to health of the patient.
There is a choice: “massage” and the “orthopedic appliances”. For example, it can be different stirrups, insole of flatfoot, braces from scoliosis, collar «chance», crutches, and wheelchair.
Or it can be manual therapy. Do not forget, every day that you lose in childhood you can’t get back. At each stage of child development there is the formation of organs and tissues. Try to avoid addiction of organism to problems. Try to find way of its solution. “It is the easiest way, take the tablet. Movement it is life. If there is something wrong in biomechanics, you should to eliminate it, but do not to anesthetize it and delay the time. At the first steps, child’s organism can suggest you by sharp pain, but tonic muscle tension can determine this. Try to find the root of the pain, but to not anesthetize it. In a severe case, for example, true hip dislocation, I am trying to make the full treatment, using the manual therapy and orthopedics together, sometimes also even surgery.
Everyone choose his own way of treatment. That was laid in childhood, and then grows. In this case, we are talking about nursling, the parents makes the choice, and don’t ask the nursling. During for a season he can scream, give sleepless nights, trying to give to understand that he is not agreed with it, but he can’t change this. If someone tells you that child, who have dysplasia will not walk, or will limp – it is wrong. The probability of lameness is only an extreme form of dysplasia — in true hip dislocation. Other children are normally walking, and apparently are not differ from their peers to a certain age. But there is danger of some horrible diseases — scoliosis, low back pain with all the associated diseases. Unfortunately, children that wear stirrups in childhood, various devices, make a massage, ultraforez, and swimming, can have a scoliosis. It is all because they are not really have a proper treatment, did not eliminate the origin cause of the problem.
Principles of hips joint dysplasia treatment:
1) Using manual methods eliminate subluxation \ dislocation.
2) Try to relax tense muscles of the pelvis and spine. It is necessary for preventing displacement of the joints.
3) Do physiotherapy for strengthen the ligaments
4) Give the time for forming the joint. Do not limit babies’ movement.
Two mothers ask our help. Their children were diagnosed with hips joint dysplasia in 3 month age. During the year they did all prescribes of districtorthopedist: were different stirrups, went to pool, donesystematicallymassages and electrophoresis. Within a year an orthopedist said that both children are healthy. But parents decided to do one more x-ray picture and hear independent opinion of another orthopedist. They dida control image(R-graphy), and found that one child I healthy, but another still has dysplasia. Mother of a first child went away, but another mom heard such word from orthopedist: “Mom where are you looking for? You child will be handicapped for a six month!” In the sad mood, she starts looking for alternative ways of treatment, refusingto use thestirrups.Soshe cameto me. Examiningchild, I saw markedfacial asymmetry, slightsquint, torticollis, tonic tension ofthe neck muscles, of back, pelvis misalignment, asymmetry of the gluteal folds and buttocks, flat-valgus foot, one leg shorter than the other. I made the procedure of correction of the spine to a child, extremities, and manual therapy of a stomach. A lot of visual symptoms are disappeared after first session. A child has changed in a better way. Later problems that he has from the birth are disappeared: florain the gut is normalized; a lot of allergenic reactions, especiallyto dust,andfood are disappeared.
During the Medical Examination at school, surgery made a conclusion – child is healthy. But the first child, as it turned out, has the scoliosisI degree. Doctors told that in the age of 1 year and 3 month he was healthy. Makeyour own conclusions!
In the age of 3 month, Kate L. has a diagnose hips joint dysplasia (congenitalsubluxation of the hip). As a tradition, child should to wear stirrups and have a massage. After the start of treatment, the child became restless, slept poorly, constantly crying, during the massage screamed and squirming. Sleepless night have bad influence at relationships between parents. Some month ago the psyche of baby was completely suppress. She wasindifferentto everything. Just at that time, her mother met with her friend, a child whom I had treated. Friend advised to ask my help. I saw girl in the age of 7 month. After examination, I diagnosed hips joint dysplasia. The symptoms are: asymmetry of the fold of skin on the legs (on the «sick» side of the gluteal fold deeper and much higher,one leg looksshorter than the other), the presence of symptoms «click» in abduction legs in different directions, turningthe footoutward. But also the child has restriction of movement of the head when turning left, increased tone of themuscles of the back. As parents told, girl badly fell asleep on the right side and often cried. On the first session, I leavethe place ofthe hip joint, aligntwistedpelvis, correctfoot, eliminated thetorticollis. I prescribed special exercises to a child. As told me mom of the child later, after first session girl became happier and calmer. Parents immediately refused from “stirrups”. Three month ago, when mom show girl to orthopedist in Clinic, he dazedly said that the girl is healthy.
Three years ago, my patient Elena in the age of 27 gave a birth to a girl. During pregnancy, she was in the hospital for the conservation; birthswere made by Caesarean section. Fetus was entwined with the umbilical cord around the neck. The patient complains of unbearable back pain, shoulder pain, shortness of movement of the hand, its frequent numbness, dizziness when you lean forward, wheezing, cramps in the heart, impotence. She became irritable, can’t find a job. After first session of manual therapy patient felt herself better. It was relief, she could breathe and move easily, hand rose easy. After three sessions, the patient felt even better than before childbirth. I amnot casual remember this example. It is great happiness that this mom was pregnant and gave birth to a child. She has a scoliosis of II degree. Later it transformed to a common low back pain in the thoracic spin and pelvis skewed. Having such changing, woman often can’t be pregnant, even having any gynecological pathology. Sometimes pregnancy endsin miscarriageorpremature birth. Even full-term baby can be in danger because of weak laborof the mother. During the pregnancy, mother’s weight increases and accordingly, increases the load on thespine, center of gravityshifts forward, costal and internal organs in the abdomen and thorax are shifted upwards. During the pregnancy very often exacerbatedchronic diseases, amplified neuralgia. During labor, the pelvis moved apart, and many other organs displaced. Can you imagine, what is the stress on the joints, spine, muscles of future mother, if she has scoliosis or any other pathology of musculoskeletal system? After birth, it should return to its original position. That’s why any woman, who is going to become a mother, even if she hasn’t any obvious symptoms of scoliosis, should to visit manual therapist until 6 month of pregnancy that is until childbirth. I am not talking about courseof rehabilitation afterchildbirth that is also necessary. Usually my patients need 3-5 sessions, for returning to normal healthy life after childbirth.
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