Orthopedic examinations of newborns are mandatory and very important for the regular growth and development of the baby, the Kumanovo hospital orthopedics explain. They advise that two examinations should be performed within the baby’s first six months. The examinations are available and mandatory under the National Screening Program.
Young Gabi Sulejmanovska is waiting patiently at the orthopedics day hospital with her newborn. This is the first examination for her baby boy. The orthopedist on duty explains to her that everything is alright with the baby and schedules another appointment after a few months.
“I do not understand certain things about swaddling the baby. The doctor explained to me what I should do, so I will heed his advice. In the past, few of my family members, that is, a few of my cousins, wore hip dysplasia braces, so I was a bit scared, but I feel relieved after the examination”, Sulejmanovska says.
Medical experts explain that there has been a drastic reduction in innate hip anomalies among newborns in the last few years. In five years, Dr. Stefan Trajanovski, an orthopedist at the Kumanovo General Infirmary, has diagnosed innate hip dysplasia only with five newborns. This disorder is treated in a conservative manner. All these years, he has diagnosed only one case of innate disorder in the anatomic growth of the hip, so the baby has been sent to the Skopje Clinic for further treatment.
“Until the mid-1980s, Kosovo, Macedonia and southern Serbia were endemic regions with the frequent emergence of this kind of disorder among newborns. Now, the frequency of this disorder has been reduced to a minimum thanks to the change in tradition and the population’s education”, Trajanovski says.
This frequent phenomenon that is typical of this region and the regional countries, that is, innate hip dysplasia, has been uprooted in our country with regular screening tests, echo examinations and regular clinical examinations of the hips of newborns and sucklings. The introduction of such examinations has enabled doctors to detect hip anomalies at an early age and among sucklings.
“If determined on time, while the hip is still made out of cartilage and connective muscle tissues, that is, up to the age of nine, there is room to apply a conservative treatment to solve this problem. The traditional swaddling of babies with adjoined knees has been changed in this region. Joining the knees during swaddling causes pressure that can result in hip dysplasia. “The tradition of swaddling babies with their knees joined is a non-physiological position that may trigger hip dysplasia”, Trajanovski explains.
He explains that there are three forms of dysplasia: subluxation, partial dysplasia and joint dislocation. The disorder often appears until two months of age and usually in one hip, most often the left one, which, according to orthopedics, is treated much more easily than that on the right hip, which occurs rarely, but is harder to treat. This disorder is more frequent in baby girls.
“The disorder that most often appears on the hip joint cup, which has an irregular anatomy, is measured during examinations in compliance with the given parameters, that is, the acetabular angle and the acetabular cup coverage. If the cup coverage is small and there is not good angle of coverage, the hip joint tends to stretch. Yet, this can be determined on time with clinical and echo examinations. The sooner it is diagnosed the better. The newborns can suffer from subluxation, partial dysplasia and joint dislocation”, the doctor explains.
However, he stresses that another risk factor here is genetic predisposition. Doctors explain that the subluxation may be a result of the mother’s hormones.
Appropriate examination and adequate education are crucial, doctors say. During certain deviations, the newborn is advised to be swaddled in a given position of its hips. The graver forms of congenital hip dysplasia, such as more serious subluxation with partial dislocation, are extremely rare.
“By the mid-1980s and the beginning of the 1990s, regular mandatory screening examination was introduced for all newborns and special education began to be provided to the young parents. With persistent work, the people’s awareness has improved significantly because babies are no longer swaddled like bread loafs”, Trajanovski explains.
The first examination of this kind should be done after the baby is second months old, or fourth month at the latest, while the second examination should be performed before the baby reaches six months of age. With these two examinations in the so-called golden period, possible anomalies can be treated conservatively, that is, through a special form of swaddling, Trajanovski explains. If the disorder is detected on time, the conservative treatment will enable the regular growth of the baby, which will grow into a healthy person with a fruitful life that will contribute to the development of its own personality and the community in general.
“If this disorder is not detected on time, but treated late and with a surgery, there are chances of hip defects which can restrict the person’s movement, cause him/her pain and result in a disability that can be corrected with expensive surgeries, but with lifelong consequences”, Trajanovski adds.
This is why the timely examination of the babies’ hips is crucial for the future development of the newborns into healthy, fruitful and creative persons.