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  • Why are babies hips checked at birth in a newborn unit ?




    After birth all newborn babies are in the  unit and you will not miss any
    baby In case of a decentred hip joint you can start with treatment
    immediately and you don?t waste time(1)
    Up to10% of newborns avoid the obligatory control of hips examinations
    for different reasons(2)
    Infants with CDH are born with a shalow acetabulum
    (type D), but the  head is kept in the acetabulum. In exceptional cases the situation is different as is commonly agreed.

    Ligamentum teres ,which keeps the head in the acetabulum, starts to elongate and grow with each movement of the leg. It is an irreversible
    Process- we are not able to shorten the elongated ligament nor the nerves or vessels inside  (going to epiphysis), that is why examination in neonatal ward is so crucial.

    There occurs also the mechanical damage of nervous fibres of nociceptive and prioproceptive  in the limbus and ligamentum teres of the Hip Joint(responsible for steering and positioning of the head in the acetabulum , (7)- they are more numerous  than in  The AC ligaments of the Knee (9)).

    Which may result in the unsuccessful treatment of the CDH due to lack of
    Co-ordination between the proper muscle tension and  child’s movement. This  makes  maintaining the correct position of the head in  the acetabulum impossble and speeds up destruction of joint cartilage. (8)

    Incorrect head movement changes also the position of the iliopsoas muscle, which presses medial circumflex artery (the main nutritional vessel) to the
    Edge of acetabulum  and  makes insertion of the head in the acetabulum impossible ,reduced  blood inflow hinders correct head growth, or destroys it if the process happens suddenly.(13)

    The above mentioned changes are instrumental to the treatment
    and if we allow them to occur, the treatment’s result never is
    never sutisfactory.
    Up till now, it is estimated, that  the same number of newborns  babies with CDH requires the hip joint replacement as about 60 years ago ,when they were the clinical examined. (4,6)



    More recent specialist literature considers screening of neonates as
    early as possible to be ideal [1,3,7, 11, 12].
    In order to guarantee successful treatment, the CDH must be detected in
    the Newborn Unit right after the birth and rebuilding of hip instability
    must be completed by 5th week of age when the  regeneration process is
    the fastest(5)
    One week of treatment after the birth equals one month of treatment later
    and there are no complications (1)

    Medical statistics show a close correlation between an early diagnosis and complications due to treatment.(8)
    What is most crucial ,an early diagnosis and appropriate treatment helps
    to prevent a risk of femur head destruction (avascular necrosis) which may
    occur as a result of incorrectly chosen treatment and delayed
    diagnosis(9).

    In extreme cases of CDH  with  late diagnosis(  even a few weeks after
    the newborn unit ) with highest (most severe)dislocation of a femur head,
    necrosis occurs in every child regardless of kind of treatment(including
    operative procedure).(11)

    Failure to detect CDH in time or inappropriate treatment will result in
    complication many year later,when it is too late for prevention.

    The ultrasound hip screening by an orthopaedic doctor is a standard in
    Germany,Switzerland Austria since early eighty in the last century,which achieve four time better results of
    operative treatment and in head destruction at least 10 time better ( at
    present  the best ever results in the world) then countries which do not
    apply obligatory ultrasound examinations

    Due to limited expenses of public health service and Lack of
    appropriately qualified doctor, decision about hip ultrasound in neonatal
    unit should belong to parents, who in majority of cases, decide to
    perform  an ultrasound hip examination, even if they have to pay for it
    additionally. They increase the chances of their child for health hip.The
    cost of a single examination is lower than complaints and costs caused
    by hip insufficiency due to congenital dislocation of the hip.

 

Why are babies hips checked at birth in a newborn unit ?




After birth all newborn babies are in the  unit and you will not miss any
baby In case of a decentred hip joint you can start with treatment
immediately and you don?t waste time(1)
Up to10% of newborns avoid the obligatory control of hips examinations
for different reasons(2)
Infants with CDH are born with a shalow acetabulum
(type D), but the  head is kept in the acetabulum. In exceptional cases the situation is different as is commonly agreed.

Ligamentum teres ,which keeps the head in the acetabulum, starts to elongate and grow with each movement of the leg. It is an irreversible
Process- we are not able to shorten the elongated ligament nor the nerves or vessels inside  (going to epiphysis), that is why examination in neonatal ward is so crucial.

There occurs also the mechanical damage of nervous fibres of nociceptive and prioproceptive  in the limbus and ligamentum teres of the Hip Joint(responsible for steering and positioning of the head in the acetabulum , (7)- they are more numerous  than in  The AC ligaments of the Knee (9)).

Which may result in the unsuccessful treatment of the CDH due to lack of
Co-ordination between the proper muscle tension and  child’s movement. This  makes  maintaining the correct position of the head in  the acetabulum impossble and speeds up destruction of joint cartilage. (8)

Incorrect head movement changes also the position of the iliopsoas muscle, which presses medial circumflex artery (the main nutritional vessel) to the
Edge of acetabulum  and  makes insertion of the head in the acetabulum impossible ,reduced  blood inflow hinders correct head growth, or destroys it if the process happens suddenly.(13)

The above mentioned changes are instrumental to the treatment
and if we allow them to occur, the treatment’s result never is
never sutisfactory.
Up till now, it is estimated, that  the same number of newborns  babies with CDH requires the hip joint replacement as about 60 years ago ,when  the clinical examin.  (4,6)



More recent specialist literature considers screening of neonates as
early as possible to be ideal [1,3,7, 11, 12].
In order to guarantee successful treatment, the CDH must be detected in
the Newborn Unit right after the birth and rebuilding of hip instability
must be completed by 5th week of age when the  regeneration process is
the fastest(5)
One week of treatment after the birth equals one month of treatment later
and there are no complications (1)

Medical statistics show a close correlation between an early diagnosis and complications due to treatment.(8)
What is most crucial ,an early diagnosis and appropriate treatment helps
to prevent a risk of femur head destruction (avascular necrosis) which may
occur as a result of incorrectly chosen treatment and delayed
diagnosis(9).

In extreme cases of CDH  with  late diagnosis(  even a few weeks after
the newborn unit ) with highest (most severe)dislocation of a femur head,
necrosis occurs in every child regardless of kind of treatment(including
operative procedure).(11)

Failure to detect CDH in time or inappropriate treatment will result in
complication many year later,when it is too late for prevention.

The ultrasound hip screening by an orthopaedic doctor is a standard in
Germany,Switzerland Austria,which achieve four time better results of
operative treatment and in head destruction at least 10 time better ( at
present  the best ever results in the world) then countries which do not
apply obligatory ultrasound examinations

Due to limited expenses of public health service and Lack of
appropriately qualified doctor, decision about hip ultrasound in neonatal
unit should belong to parents, who in majority of cases, decide to
perform  an ultrasound hip examination, even if they have to pay for it
additionally. They increase the chances of their child for health hip.The
cost of a single examination is lower than complaints and costs caused
by hip insufficiency due to congenital dislocation of the hip.

 

 

somatic sense - the faculty of bodily perception; sensory systems associated with the body; includes skin senses and proprioception and the internal organs

somaesthesis, somataesthesis, somatic sensory system, somatosensory system, somesthesis, somaesthesia, somesthesia, somatesthesiainteroception - sensitivity to stimuli originating inside of the bodycutaneous senses, sense of touch, skin senses, touch modality, touch - the faculty by which external objects or forces are perceived through contact with the body (especially the hands); "only sight and touch enable us to locate objects in the space around us"proprioception - the ability to sense the position and location and orientation and movement of the body and its partsskin perceptiveness, tactility, touch perception, tactual sensation - the faculty of perceiving (via the skin) pressure or heat or painfeeling of movement, kinaesthesia, kinesthesia - the perception of body position and movement and muscular tensions etc

 

 
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