The incidence of the developmental disorders on the hip in the territory of the municipality of Strumica from 2014 until 2017

Developmental hip dysplasia or congenital hip dysplasia is one of the most severe disorders of the locomotors system. It covers a wide range of dysfunctional behavior of the hip instability with a loose capsule up to complete luxation of the thigh bone with poorly developed acetabulum. In fact, this disorder is disturbed by the normal anatomy of the hip joint because there is an abnormal connection between the head of the thigh bone and the acetabulum. It usually occurs before birth or after birth during early childhood, and if it is not treated appropriately, there may be walking disorders or in some cases it can come to total invalidity.
The etiology has not been elucidated yet, but there are several things that may cause some risks: female gender, genetic predisposition, pelvic childbirth, and of course developmental dysfunctional behavior of the lower limbs.
Clinical signs that are present during hip dysplasia are: Asymmetrical lower limbs and skin folds of the thighs, limited abduction, pain, a positive sign for Ortolani and Barlow, contractures, and of course muscle weakness. There are used many tests for diagnosis, but the most famous are those of Marks – Ortolani as well as the tests of Barlow and Palm.
These tests are made by a specialist orthopedist in order to avoid further damage to the skeleton. For accurate diagnosis in cases for newborn babies an ultrasound is highly recommended, and if there is a fear of a luxation then they use radiographs. The sooner this anomaly is discovered, the simpler the treatment will be and also more effective. Treatment can be conservative and surgical. Preventively with a therapeutic effect, it is recommended to wear special orthopedic panties and suitable diapers. With the hip restoration the right thing that is achieved is the joint stability and for that purpose various orthoses or orthopedic casts are always used. The conservative treatment usually lasts longer, perhaps even up to several months, so if there are not any positive results, surgical treatment is initiated. Surgical treatment depends on the age of the patient as well as the degree of disorder, so different operational procedures are applied.
In both treatments, the use of kinesitherapy, physical medicine and rehabilitation have a special role and important meaning.
Keywords: hip, congenital dysplasia, luxation, subluxation, kinesitherapy.