For many mothers, unsymmetrical folds in a baby are a cause for panic. However, you should never panic when raising children. Most experienced mothers will tell you that asymmetrical folds on the legs are one of the signs of newborn dysplasia. But without a full examination and examination, it is too early to talk about the presence of this disease.
What should be the location of the folds?
Everyone knows that a newborn is examined by a pediatrician to study his breathing, heart function, skin condition and the location of folds on the lower extremities. If you put the baby's two legs together, the inguinal and knee folds should mirror each other or form one horizontal line. In the absence of the described picture, they speak of congenital underdevelopment hip joint. To clarify the diagnosis, the child is examined by an orthopedist, placing him on his tummy and straightening his legs.
If both legs are the same length and there is no symmetry of the folds, then it is recommended to wait a while. There is no need to worry: in a couple of months the folds will even out.
If the length of the legs is different, the child cannot move them apart, and a click is heard during forced extension, then they speak of an orthopedic deviation. The child is referred for examination to an orthopedist.
It’s not for nothing that young mothers are afraid of asymmetrical folds. But you shouldn't self-diagnose. Only a doctor will correctly diagnose and tell you what to worry about.
What does lack of fold symmetry mean?
Often, asymmetrical folds appear with increased muscle tone in the newborn. To reduce it, use a special massage for infants.
Sometimes asymmetry can be a congenital feature. She doesn't get away and doesn't threaten anything. But only a medical specialist, or better yet two, should tell mom about this.
Dysplasia is a fairly common disease, especially in girls. Look for additional signs: poor leg spread, clicking, different leg lengths.
How to detect asymmetry of the leg folds
When the mother changes the baby's clothes or gives him a massage, you need to pay attention to the location of the folds on the legs. They should be located symmetrically relative to a line running along the child's spine. If the two halves are almost identical and there is no curvature, then there is no problem.
When the baby is lying on his tummy, you need to fold his two legs tightly. The folds located under the butt should come out of one place. If this is not the case, then you need to visit an orthopedist for consultation.
Check hip mobility. Place the baby on his tummy and hold his butt with one hand. With the other hand they take the right knee and try to move it to the side, bending the leg at the hip. If resistance is not felt and the butt lies in place, then move on to the second leg. Compare the work of two legs.
Treatment of dysplasia
Dysplasia is a hereditary disease or indicates a woman’s hormonal imbalance during pregnancy.
For correct and effective treatment the child must pass ultrasonography hip joint.
If a child is born with injuries or ahead of schedule, then its development will be slowed down a little. Such children are additionally sent for examination at five months.
An integrated approach is used to treat the hip joint. The child goes to shanks for some time or uses wide swaddling, massage, physiotherapeutic procedures and therapeutic exercises are attributed.
It is better to carry out treatment at an earlier stage, since the child is still lying down and can more easily tolerate any restrictions on movement.
A sling will help spread your legs wide for proper development of the hip joint, which will help the mother carry the baby in an upright position.
It must be remembered that only a doctor will finally make a diagnosis and prescribe treatment. The mother should closely monitor the child's condition. If you find anything suspicious or alarming, immediately contact your pediatrician, who will refer you to the right specialist. Only early diagnosis will help avoid complex treatment and dangerous complications in the future.
Before discharge, the neonatologist talked at length about how to care for the baby. She was supposed to show you how to properly handle the umbilical remnant of newborns, how to clean the nose and ears. Having pressed the baby’s legs together, the specialist probably drew your attention to whether the folds on the baby’s legs at the groin and knees are symmetrical.
Asymmetry of the folds may indicate that the baby has dysplasia, so it is important to monitor whether they are located equally.
The asymmetry of the arrangement of folds on the legs of newborns, as a rule, is noticed already in the maternity hospital. Their unevenness may indicate underdevelopment of the baby's hip joints. The neonatologist will place the baby on his tummy, straighten his legs and compare their length. If it turns out to be different, this will indicate the presence of pathology in the baby. It will be difficult for him to spread his legs to the sides, and with this movement a distinct click will be heard in the joint.
With timely complex therapy, this orthopedic problem is resolved quite quickly. If dysplasia is not cured in time, it can turn out badly for the child: it will be difficult for him to learn to walk, and due to the pathology, the baby will limp.
In order to diagnose the presence of pathology in a timely manner and not miss time for treatment, the orthopedist examines children three times in the first year of life: at your first visit to the clinic at 1 month, then at 3 months, the final examination will take place at the commission. The doctor will compare whether the folds on the legs are symmetrical and evaluate the same length of the lower limbs. The dynamic picture will allow the specialist to monitor the development of the infant’s musculoskeletal system.
But different lengths of the limbs and the fact that the folds on the legs are not symmetrical do not always indicate the presence of dysplasia in the baby:
- sometimes a baby’s legs may be of different lengths due to muscle cramps; over time, the tone will go away, the limbs and folds in the groin and knees will become symmetrical;
- rare, but there are cases when the asymmetry of the folds is a congenital feature and has nothing to do with the hip joint, but this can only be verified based on the results of an x-ray.
Treatment of dysplasia
In case of a simple pathology, the orthopedist will prescribe you a course of therapeutic massage, he will help the baby relieve hypertonicity and develop the joint so that the joint begins to function as expected. You may have to repeat the sessions several times before your baby gets rid of the orthopedic pathology.
In severe cases, specialists will insist on using a Freik splint or Pavlik stirrups. These orthopedic devices fix the baby’s joints in the correct position, they spread the child’s legs to the sides and slightly bend them. The sooner you diagnose a pathology in an infant and the sooner you begin treatment, the faster the baby will get rid of it.
How to determine pathology yourself?
- The folds at the groin and knees of the baby are not symmetrically located.
- When the legs are brought together, it is clear that the folds come from different points.
- The folds have different depths.
- When lying on the stomach, the child is capricious and tries to change position.
After the birth of a newborn, he is examined by specialists right in the maternity hospital. They pay attention not only to the functioning of the respiratory and cardiovascular systems, but also to the condition of the skin and the symmetry of the folds of the lower extremities. Normally, the knee and inguinal folds should be at the same level, otherwise the child may have dysplasia (underdevelopment) of the hip joint.
How to determine the asymmetry of folds?
Parents can determine the asymmetry of the baby’s folds themselves. Undress the child, lay him on his stomach and mentally draw lines along his spine. If everything is in order, then both halves will be almost the same.
Pay attention to the folds under the buttocks. To do this, press the baby's legs together. The folds under the buttocks should be symmetrical. If this is not the case, then specialist advice is required.
Main reasons
If you discover asymmetrical folds on your child’s legs, you should not immediately panic; perhaps this is just an anatomical feature and the baby does not have any pathology. But it’s still worth showing the child to a specialist. It is better to spend a few hours on additional examination than years on treating an advanced disease.
Quite often, the folds in babies are not the same due to hypertonicity. In this case, you need to consult a neurologist, especially if you notice chin tremor in your baby.
Usually, with increased muscle tone, massage, physical therapy, electrophoresis with medicines(for example, with aminophylline, papaverine, dibazole, magnesium sulfate), paraffin wraps. If you have increased tone, aromatherapy and a visit to the sensory room will be useful. Asymmetrical folds may indicate dysplasia. Especially if, in addition to unequal folds, the child has the following symptoms:
- One of the baby's legs is shorter than the other.
- His legs are difficult to move in different directions.
- There is an extra fold on the thigh.
- When the child moves his lower extremities, a clicking sound is heard.
To determine the length of the lower limbs, the baby is placed on his back and the legs are bent at the knees at an angle 90 degrees. Then, slowly, they are pulled out, placing some object with a flat surface under them, for example a book.
To determine the mobility of the joints, the baby is laid on his stomach, one hand is placed on his buttocks, the other hand is taken by his left knee, the leg is bent at the hip and the knee is carefully turned to the left. The baby's lower limb should be easily retracted to the side. The same manipulations need to be carried out with the right leg and the movement of both limbs is compared.
Having discovered any of these signs, parents should immediately contact a specialist, as the child may have dysplasia. It can be determined using x-rays. Dysplasia is more common in girls than in boys.
If a newborn was born prematurely or had some kind of birth injury, then the baby may be slightly behind in development, so such a test should be carried out when the child is 5 months old.
In order to identify pathologies in the development of the musculoskeletal system, all one-month-old infants are prescribed a routine ultrasound of the hip joints. Also, children under one year of age should be shown to an orthopedist. Babies undergo routine examination at the ages of 1 and 6 months.
You should not delay the scheduled examination, since the detected pathology in early age easier to treat. Parents' task carefully monitor your baby's health, notice everything that worries you and do not hesitate to ask questions to a specialist.
What to do if asymmetry is caused by dysplasia?
Hip dysplasia is an underdevelopment characterized by abnormal development of connective tissues and increased mobility of the femoral head.If the disease is diagnosed quite early, then everything can be corrected - It is important to immediately consult an orthopedic doctor.
The essence of the treatment of dysplasia is to fix the head of the femur in the articular cavity so that it is overgrown with ligaments and no longer moves to the side.
You need to know that with dysplasia, the femoral head falls into place when the baby’s lower limbs are bent and spread apart. If the child is always in a diaper that is 2 sizes larger, and it does not allow the baby to bring his legs together, this is already good prevention diseases. Of course, if the case is not very advanced.
At home, parents can do massage and gymnastics, which the doctor will teach. Carrying the child in carriers in which the child’s legs are constantly spread apart will also help. In addition, you need to use wide swaddling: the baby’s upper limbs are fixed to the body, while the lower ones remain free.
In more severe cases, doctors recommend the use of special orthopedic products: Freyk's pillow or Pavlik's stirrups. These devices allow you to keep the child’s legs in the correct position: apart and slightly bent. When dysplasia is detected, parents need to be patient, since the therapy will be long-term and will only give a positive result if adults carefully follow the recommendations of the attending physician.
If asymmetric folds are detected in a baby, parents should not make a diagnosis on their own, much less engage in self-medication. All this should only be done by a specialist.
The literal meaning of dysplasia is abnormal growth. The cause of the disease is inadequate development of muscle, bone, cartilage, nervous tissue, ligaments and requires mandatory treatment. In newborns and babies up to one year old, in most cases, hip dysplasia is diagnosed. It manifests itself in the incorrect position of the femur at the point of attachment to the pelvic ring. In most cases, the disease is congenital, less often - acquired.
Why is it important to diagnose immediately?
Deviations in the development of the musculoskeletal system in a newborn are the cause of impaired musculoskeletal function. Successful treatment is possible if the diagnosis is made in the early stages of the disease. In this case, adverse consequences for the future development of the child can be avoided. Untimely treatment and severe progression of hip dysplasia can lead to lameness and disability.
Signs of the disease
In the neonatal hospital to identify hip dysplasia. Dr. Komarovsky notes the importance of examination in the first days of a baby’s life and subsequent mandatory examinations. Particular attention is paid to children at risk:
- premature;
- large;
- during difficult pregnancy;
- pelvic position of the fetus before birth.
Parents need to pay close attention to the condition of the newborn and contact a pediatrician if the following symptoms are detected.
Asymmetrical inguinal and gluteal folds
If you put the baby on his tummy, three folds are visible under the buttocks on both straightened legs, which healthy child continue each other. With dysplasia on the side of the affected joint, the folds are located higher, and sometimes an additional fold is formed on the thigh.
Komarovsky notes that asymmetry also occurs in healthy children, so it cannot be included in the symptoms required for the disease. The folds will be symmetrical in a newborn and with bilateral hip dysplasia.
Limited leg movement
The baby needs to be placed on his back, his legs bent at the knees and spread in different directions as in the photo to create a “frog” pose. For a healthy baby this will not cause any discomfort; the knees almost touch the surface on which he is lying. If a joint is damaged, it is difficult for him to take such a position: the incorrect joint location prevents him from straightening or spreading his legs strongly.
This method of identifying abnormalities in the development of the hip joints in a baby gives more accurate results and is an important reason to consult a doctor.
Clicking sound when moving
Bending the baby's leg or abducting it to the side causes a clicking sound, which is caused by the reduction of the dislocated joint. When moving back, the click is repeated.
This method is the most reliable for diagnosing hip dysplasia in children under one year of age. It allows you to identify the disease in a baby at the earliest early stage, but with a mild disease, the signs disappear on the 8th day after birth. The presence of extraneous sounds and crunching sounds when bending and extending the joint should alert parents.
One leg is longer than the other, which is noticeable externally
If you bend your legs and place your feet on the surface where the baby is lying, your knees should be at the same level. On the side of the affected joint, one knee will be lower than the other. Based on this feature, it is difficult to identify bilateral dysplasia.
At the slightest suspicion, you should consult a doctor to rule out symptoms of the disease, or begin urgent treatment if the disease is confirmed. To diagnose the disease, X-ray or ultrasound examination is often used.
X-ray
X-rays are ineffective in identifying the presence and extent of the disease in an infant. In a newborn, the areas under study—the femoral head and the pelvic ring—consist of cartilaginous tissue, deviations in which are not visible on an x-ray. This does not give a complete picture and requires additional calculations.
Ultrasound
Ultrasound helps to accurately establish or exclude a diagnosis, which is harmless to the child and does not cause any harm. pain. It allows you to detect the disease in newborns and children under 3 months.
Other signs
If a diagnosis is not made at an early stage and treatment is not prescribed, other signs appear:
- Limping. Before one year of age, most babies begin to walk; due to lameness, a “duck walk” is formed.
- Pain in a deformed joint, especially when moving, which may be accompanied by crying, whims, and a clear reluctance of the child to move.
- Deformation of the pelvic bones, which in severe cases leads to problems with internal organs.
Forms of the disease
Dysplasia is also called joint dislocation and has several stages.
Immaturity of the hip joints
A slight deviation from the norm, which is characterized by some thickening in the recess pelvic bone. Due to the formations, the head of the femur is partially covered. This deviation is common in premature babies. If over time the joint develops fully and the disease does not progress to another stage, then treatment is not required.
Pre-luxation
It consists of an incorrect ratio of the sizes of the acetabulum and the femoral head, which may be slightly larger or smaller and extends upward and to the side.
Subluxation
Accompanied by a shift of the head of the femur and its partial exit from the recess of the acetabulum. At the same time, their contact is maintained.
Dislocation
It is characterized by complete displacement of the femoral head in relation to the recess of the pelvic bone. This severe degree of hip dysplasia leads to the inability to fully function the limb, sometimes to rupture of the joint. When it is detected, urgent treatment is necessary to avoid the persistent formation of pathology and possible disability.
Causes of the disease
There are several factors that cause dysplasia in children under one year of age:
- The longitudinal position of the fetus and complications during childbirth cause hip dysplasia in children. Features of the intrauterine position of the child often cause signs of joint deformation on the left side;
- The disease can be transmitted hereditarily through the maternal line in almost a third of cases. In newborn girls it occurs several times more often;
- A child's lack of B vitamins, calcium minerals, iodine, iron, phosphorus, and vitamin E provokes the development of dysplasia. The formation of musculoskeletal tissue in children begins after a month of intrauterine development. A significant proportion of babies with joint damage are born in the winter, which is caused by a spring deficiency of vitamins in the diet of a pregnant woman and vitamin deficiency in the child;
- Metabolic and water-salt imbalances interfere with normal tissue formation;
- Diseases of the endocrine system and infectious nature during pregnancy, application medicines may cause complications in the child;
- Hormonal disorders. Before birth female body produces more progesterone to relax the ligaments and muscles for the passage of the baby through the birth canal. In excess, the hormone enters the baby’s body, contributing to weakness and deformation of the ligaments. In a newborn, the level of progesterone normalizes in the first days of life, the elasticity of the ligaments is restored and the dislocation can straighten itself;
- Spinal cord development disorder is one of the common reasons diagnosing dysplasia in children under one year of age;
- Restriction of fetal movement during pregnancy due to increased muscle tone of the uterus or a small amount of amniotic fluid. Lack of activity prevents the normal formation of the musculoskeletal system;
- The unfavorable environmental situation in some areas causes an increase in the incidence of newborns by 3-4 times compared to those who live in favorable conditions;
- Tight swaddling for up to a year contributes to the development of acquired dysplasia, especially in children with weak ligaments. As a result of a study of morbidity in African countries, where children are almost never swaddled, Japan switched to loose swaddling or abandoned it. This made it possible to reduce the level of the disease by almost 10 times.
Treatment of the disease at an early stage gives good results, so it is important to contact your pediatrician promptly if your child suspects signs of the disease. In this case, complex therapy is carried out, and, if necessary, surgical treatment.
Before receiving a discharge from the maternity hospital, a woman must learn how to properly care for her child. Junior medical staff and a neonatologist will help her with this. Particular attention should be paid to caring for the navel area and cleaning the ears and nose. Asymmetrical folds on the legs of an infant are revealed by flexing the limb. Parents should pay attention to the knee and groin area. If there are abnormalities in the child, dysplasia is suspected. That is why asymmetry should be monitored even after the baby is discharged from the hospital.
Causes
If a child’s limbs are not symmetrical, this will be discovered in the maternity hospital. This situation occurs in the case of insufficient development of the hip joints. To diagnose it, babies are placed on their tummy and try to straighten their legs as much as possible. In this case, attention is primarily paid to the length of the limb. The asymmetry of the folds indicates a pathology in the development of the child inside the womb.
The clinical picture in infants is considered aggravated if tension is felt when trying to separate the limbs. Additionally, a characteristic clicking sound may be heard in the legs.
An orthopedic problem in newborns can only be solved if a timely visit to a specialist is made. Otherwise, dysplasia will only get worse, which will lead to problems in walking. In the future, the baby develops lameness, which will remain for life.
If there is asymmetry in the gluteal folds, you should consult an orthopedist
During the first year of life, the child must visit him at least three times. For this purpose, 1, 3 and 6 months of the child’s life are selected. If necessary, you will need to hear the authoritative opinion of the commission. Its members will carefully study the folds and length of the limbs. The dynamics of development of the overall picture are also taken into account. Dysplasia in children can be diagnosed based on an analysis of the presence of other symptoms:
- Different limb lengths occur when seizures occur periodically. They negatively affect muscle tone, so the position of the folds is disturbed. As a result, clear changes in symmetry are observed.
- There are also cases when asymmetry of the folds is considered a congenital feature of the child. The situation is not affected in any way by the position of the hip joint. However, a final conclusion can only be made based on the X-ray results.
Diagnostic methods at home
Parents should pay close attention to their child and periodically perform special examinations:
- A detailed study of the folds on the legs reveals a lack of symmetry in the area of the knees and groin.
- When you try to bring the legs together, you get different states of bends on the limbs.
- Deeper folds are observed on one leg.
- If mommy tries to put the baby on his tummy, he immediately begins to be capricious. Additionally, he wants to change his position as quickly as possible.
Parents' actions
Don't panic if you find irregular shape or depth of folds. There is nothing wrong with a diagnosis of dysplasia if you seek help from a specialist in time. Parents should listen carefully to his recommendations and follow them in the future. The course of treatment is selected depending on the individual case.
However, there are also general parameters:
- Massage and electrophoresis help to quickly and effectively get rid of hypertension. The duration of the course and intensity of exposure are determined by a neurologist. Parents will be able to see positive results after just a ten-day course.
- The examination may not reveal any violations. In this case, different folds may appear on the background individual characteristics the child's body. In this case, treatment is not necessary. However, massage will help improve your health. Thanks to it, bones and muscles will form correctly.
- If dysplasia is confirmed, an orthopedist will be able to choose the right course of treatment. It is important that he also controls every stage of it.
Therapeutic measures
If the disease develops in a mild form, then the child needs to attend a massage. Thanks to it, it will be possible to reduce muscle hypertonicity several times. The norm is noted only if the nodes begin to function correctly. The doctor examines the little patient in detail and prescribes the number of sessions. They will help once and for all get rid of the pathology that negatively affects the child’s gait.
If the folds are uneven, then in some cases Freik splints or Pavlik stirrups will help get rid of the disease. With their help, it will be possible to fix the lower limbs in the required position. At the first stage of treatment, you only need to slightly spread your legs and bend them slightly. Parents should understand that it is important to diagnose the disease as early as possible. In this case, you can move on to treatment, which is guaranteed to give an excellent result. The baby will be able to continue to grow and develop properly.
Special splint for the treatment of dysplasia in infants
Preventive actions
Scientists have recorded cases where a child's joint was reduced on its own as it grew older. However, this can also be achieved by regularly being in a position that promotes reduction. If necessary, the orthopedist prescribes additional actions to speed up the healing process.
Doctors note that self-reduction is observed only in children under three months. Parents should not swaddle them tightly. Otherwise, the risk of harm to health increases. Swaddling must be done in a special way. To do this, a thick diaper is threaded between the legs, to secure which you will need a second sample.
As a preventive measure against dysplasia, parents should do special gymnastics with their child every day. It involves circular movements of the legs and pelvis. At this stage of development, the child has flexible bones, so reduction can occur independently. In this case, parents will be able to completely forget about the serious diagnosis.
If dysplasia could not be diagnosed before three months of age, then the likelihood of its self-reduction increases. Recommends that parents use only loose swaddling methods. Gymnastics also has a positive effect. As a preventative measure, it is recommended to visit the office once every three months for the first six months of life. Thanks to this, it will be possible to identify pathology at the first stage of development. The sooner this happens, the greater the likelihood of achieving a positive result within a short time. If dysplasia is not treated, the baby may have problems with sitting and walking.
