The first visit to the orthopedist

The first visit to the orthopedist.

The first orthopedic examination of the child is held, usually in 3 months — up to this point podiatrist usually hard to do any conclusions about its development. However, there are boundary conditions that can be detected in the first week of life, in these cases, the early start of rehabilitation will be the key to further the child's welfare.

Let's do a joint orthopedic examination of your baby. First, let's see how the baby is lying in bed: know whether the body, we see that he is calm, and examine it, they say, from head to toe.

Head and neck

Carefully inspect the head of your child, pay attention to its shape, it must be symmetric. But adults should attract the attention of not only the shape but also the position of the head. Turns to her baby all the time, or tries to look in one direction? In the latter case, the orthopedist can ascertain the formation of the usual head-turning— The boundary conditions, which, if time does not take action, can lead to the development of a one-sided skull deformation (the so-called "beveled neck").

Causes of the usual rotation of the head may be different — and birth injuries (kefalogematomy, a broken collarbone), and improper handling of a child when the parents are constantly coming to bed with one hand, without shifting the child head in different directions.

But perhaps the most unpleasant diagnosis associated with the improper position of the head — this is muscular torticollis (Trauma sternocleidomastoid muscles of the neck, as a result of which the head is making the wrong position). It is not always diagnosed in the hospital, but already in the first week of life, the mother can pay attention to the forced position of the baby's head (the slope in a sick way, turning into a healthy chin). If you try to change the position of the baby's head begins to show signs of anxiety, his little face appears painful grimace. A little later, the parents may notice the asymmetry of the face side: torticollis marked decrease in the volume of the buccal muscles. When trying to test the neck muscle with a sore hand, we can detect a dense formation (1 to 3 cm), painful to the touch.

Congenital muscular torticollis requires immediate qualified treatment consisting of physical therapy, massage, application of special packings (pillows, cushions, etc.) to the head. With early detection and timely treatment of torticollis removed without surgery.

Spine and thorax

When you have finished viewing the head and neck, go to the spine and rib cage, but this step inspection must precede a small excursion into the anatomy.

Adult spine is not straight, it has a physiological bends — kyphosis (External bending — when viewed in side elevation human, this bend is directed back toward the back) andlordosis (Internal — geared toward the chest):

  • cervical lordosis;
  • thoracic kyphosis;
  • lumbar lordosis.

All these curves are generated in the first months of life. For the correct formation of vertebrate bending spring effect occurs and further backbone easily transfers axial loads due to good damping vertebrae, but smoothness of at least one bend, this effect disappears and the spine have irrational load testing that promotes the development of many diseases, such as scoliosis (Lateral curvature of the spine) osteochondrosis (Restriction of mobility of the spine), etc.

So, back to the inspection. We put the baby on his stomach with legs bent at the knees ("frog posture"), and make sure that the spine is located on the midline. Sometimes the child may experience "Infantile scoliosis". Most often it is accompanied by neurological symptoms (muscle dystonia, hypertonia) — with its elimination is reduced and the normal position of the spine.

Sometimes, when viewed in this position in the child revealed a deviation of the vertebral axis ago — the so-called kyphosis of the lumbar spine, It is mostly found in children born large enough and quickly passes, if the first three months of a child's life properly keep on hand, do not try to put, put on the legs (many parents like to arrange with the child "poprygushki" — this can not be done) .

Parents should be aware that the formation curves of the spine goes in stages: first, the child begins to hold her head — it contributes to the formation of the cervical lordosis. It is worth recalling that the use of pillows in children interferes with the formation of the bend. When the baby starts to sit down (and it does it gradually, if it does not interfere with adults), formed by the thoracic kyphosis and lumbar lordosis. If the child sit in a chair at any time, instead of the twists he can form thoracolumbar kyphosis, so-called "round back."

If you want to try on your baby invention of modern industry, then you should first try to imagine how it will affect theMusculoskeletal system of the baby. Do not rush to purchase for their child seat, walkers, jumpers, playpen. First of all, take care of the right mattress: it must be elastic, dense, it should not remain dented after sleep.

First 2-3 months of life, the child should lie on your back or stomach. It is not necessary to turn it on its side, as poorly developed lateral muscles hold the body still bad, the entire burden falls on the spine, and at the position of the child on the side of scoliosis can occur. With3-4 months, the child begins to roll their own, and from that moment he chooses a comfortable position: on your back, stomach or side. During this period the mother should follow, with the same frequency if the kid flips through the left and right sides. Preference for one side may indicate residual effects muscular dystonia (Different tone muscles on the left and the right). These effects need to be addressed until the baby starts to sit down:

  • First, different strength of muscles of the left and right side of the body more difficult developing skills at landing (the child will be filled up in the same direction and may lose the desire to keep trying)
  • second landing in such a situation can trigger the formation of scoliosis.

Perhaps at this time it is advisable to massage course, give the child a swim in the large (adult) bath, it will help get rid of unwanted asymmetries in muscle tone.

Hips and legs

Let's go back to the orthopedic examination of our baby. Next, no less important stage — the hip joints. To evaluate the function of the hip joint, the child should be put on his back, his legs bent at the knees and try to spread them apart. You should not do it abruptly, with the use of force. It may not like the kid, he will strain your muscles and will not spread his legs.

When done properly, this test can usually take your feet so that the knees touch the table where the baby is lying. Limitation of abduction can be due to various causes. The most common (and easily eliminate) the cause is spasm leading (internal thigh) muscles. In this case, will the wide diapering (ie, one in which the child's hips are pressed against each other and get divorced at some distance), swimming in the warm water, therapeutic exercises. If mom says that hip abduction on the one hand is more limited, it is necessary to draw the attention of a physician.

The next stage of the inspection — checking the symmetry of the gluteal folds and leg length, to carry it out, place the baby on his stomach. It is necessary to see a specialist if you notice the asymmetry of the gluteal folds or different length legs. These symptoms may occur in some diseases.

Making sure that th
e hip joints are formed correctly and function they are not broken, look at the foot. Note the position of the foot, it should be in the middle position. If you notice that the foot is not directed straight ahead, but slightly angled horizontally inward or outward (ie, a so-called rotation of the foot) As soon as possible to begin foot massage. Special massage course will eliminate the incorrect position of the foot is already in the first month of life. In more severe foot deformities may use corrective splint that allows you to fix the foot, while the child has not yet begun to walk. Remember: any slight deformation of the feet is easily eliminated in the early period of life, but much more work has to spend on treatment initiated after the child has gone.

So, we hope that as a result of our inspection you realize how important it is to closely monitor the condition of the child, to celebrate the disturbing symptoms and conduct timely treatment. However, it is equally important not to rush the development of the baby, it does not fit, do not try to "help", and patiently wait until he is willing and able — to sit down, get up, go. Parental love should be attentive and patient, only then it will bring forth fruits worthy, and your child will grow up healthy and happy.

According to the magazine "9 months" Number in September 2001

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