Table of Contents
Introduction
The presence of abnormal cell mass characterizes Dysplasia. Such abnormality often leads to structural and functional impairment of the tissue or organ. However, such changes are often caused by different chemical and environmental factors. In a few cases, such deformity can be seen since birth. Such conditions are known as developmental dysplasia. Developmental dysplasia of the hip is a well-known condition that causes structural and functional impairment.
What Is Developmental Dysplasia of the Hip?
The hip joint is one of the most important joints in the human body. It serves as a junctional part of the upper and lower parts of the body, facilitates various leg movements, and helps in locomotion. The pelvic bone and the thigh or femur bone form this joint.
The head of the femur forms the head portion of this joint, while the acetabulum forms the socket portion. Developmental dysplasia of the hip joint occurs when abnormal developmental formation is observed. This condition is mainly seen in children and infants. Almost one out of every 1000 children worldwide is affected by this condition.
The potential risk factors associated with this are;
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Sex: Girl children are more commonly affected by developmental dysplasia than male children. The prevalence of such conditions is more than four times higher among girls than boys. Though the exact reason for such a high prevalence is unknown, some researchers say a high level of maternal hormones provides high joint laxity.
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Breech Position: During normal birth, the head of the child is usually positioned at the bottom. However, in some instances, the feet are positioned at birth. Such condition is seen in around three to five percent of cases. This position is known as the breech position. Such a condition is associated with an increased incidence of developmental dysplasia of the hip.
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Family Factors: In most cases, hip developmental dysplasia is associated with familial history. Researchers highlight the involvement of genes such as COL2A1, DKK1, HOXB9, HOXD9, and WISP3 in such cases. Also, the presence of proinflammatory mediators in the family due to osteoarthritis has been linked to this condition.
All these factors cause poor development of the hip joint structure. Such structural deformities cause repeated joint dislocation and subluxation of the joint.
The symptoms of developmental dysplasia of the hip include.
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Instability of the hip joint, which may lead to limited abduction of the hip.
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Poor strength of the hip joint.
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Difficulty in walking and poor gait of the toddlers.
What Is the Application of Splint in Developmental Dysplasia of the Hip?
The splint is a rigid device that helps to keep the body parts in a particular anatomical position. Such devices prevent injury by preventing or restricting the movement of the mobile parts.
The indications of splinting in the developmental dysplasia of the hip joint are;
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Certain hips may stabilize on their own. In such cases, some clinicians may opt for several weeks before reassessing the child and considering the commencement of treatment. In these cases, a splint can be provided.
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In certain cases, doctors must take follow-up measures. Failure to do so may cause hip dislocation, in which case a splint is a brilliant idea.
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A splint can be provided as a protective measure if any abnormality is detected during ultrasonographic examination. In such cases, the hip joint may appear normal in clinical and radiographic examinations.
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In cases where the hip joint has been dislocated, it can be reduced by the doctor during examination.
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Cases where the doctor may cause the subluxation (a partial dislocation of the joint) of the joint during examination.
What Is a Von Rosen Splint?
Professor Sophus von Rosen of Sweden developed these splints in 1956. These splints are used to prevent permanent displacement of the hip in children born with unstable hips. The child must wear this splint for at least six to twelve weeks.
The aims of this splint are;
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The hips must be flexed over 90 degrees and abducted between 60 and 70 degrees to keep the femoral head centered in the acetabulum.
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To prevent avascular necrosis (AVN) of the femoral head, it is necessary to allow some degree of hip movement within the splint while avoiding forced abduction.
Wearing the check-up at a regular interval is necessary. An ideal check-up is once a week. During a check-up, the splint position and underlying skin condition must be checked. An ultrasonographic evaluation must be done every four weeks to check the prognosis.
What Are the Precautions Associated With the Splint?
The parents should maintain certain precautions during the treatment phase.
These are:
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The splint should not be removed at home or by any ordinary person. It should only be removed by professional healthcare providers.
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While wearing this splint, the child should lie on its back, not tummy.
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The child's mother or caregiver should always maintain the child's hygiene during this period. The diapers should be changed frequently. The splint and the skin around it should be cleaned thoroughly. Accumulation of moisture under the skin may cause skin rashes. Powdering the child and the splint with unperfumed powder is helpful. When bathing the child who is still in the splint, it is advisable to utilize soap that is free of fragrances. Following the washing process, gently pat the skin dry with a towel to ensure it is thoroughly dried.
Conclusion
Developmental hip dysplasia is related to family and birth-related factors. These factors cause structural deformity of the hip joint, which leads to dislocation. The Von Rosen splint is used in infants to stabilize the hip joint and prevent repeated dislocation. However, proper care and repeated check-ups are needed while using the splint.
