Question

types of pediatric focused musculoskeletal problem

Answer 1

Answer = In Musculo Skeletal system many disorder such Hip Dysplasia, Club foot and Scoliosis are generally occured in child and infant.

Hip Dysplasia = It is one of the most common congenatal malformation in infant.

- It is the condition in which head of femur is seated improperly in the acetabulum or hip socket of pelvis.

- It may be congenital developed after birth.

- Hip Dysplasia mainly present in female child ( More then 8 times than male )

* Classification of hip dysplasia = Hip dusplasia mainly 3 types.

1.Acetabular dysplasia = It is mild form of hip dysplasia inwhich acatabulam cavity is too shallow or deformed.

2. Subluxation = It is the most common type of hip dislocation. It is also known as incomplete dislocation of hip.

3. Luxation= There is no contact between head of femur and acetabulum cavity.

Etiology = A. Physiological causes = Estrogen hormone increse the chances of hip dysplasia .

B. Mechanical causes = It include several cause such as ntrauterine position of fetus.

C. Genetic causes = The child who has parent with abnormal chromosome have high chances of hip dysplasia . ( chromosome 13 abnormalty ) .

D. Neurological Disorder = may lead to dislocation of hip caused by diminished muscle strength in holding the femur head into acetabulum.

*** Assessment = Infant should be relax during hip examination and this can be achieved by a giving a pacifer or bottle.

-If the child have asymmetrical skin fold on the medial aspect of thigh and gluteal fold it is consider as hip dysplasia.

- If one knee is lower than other when infant is on the back with the knees flaxed, dislocation is present this sign is known as allis sign, galeazzi sign.

- Barlow sign a also examine .

Ortolani sign - In this test apply a force by the middle finger on the back of hip in forward and inward direction this pressure will put femur head into the acetabulum and a click sound felt. and positive trendelbag test also done.

X- Ray is the confirm diagnosis if shenton line does not result in smooth arch.

Intervention = A rigid device such as friejka pillow or pavlick harness may be use because these device permit some movement of leg.

- Splint is used in last.

- Buck skin traction

Nursing intervention=

- Maintain correct position of hip.

- The nurse should explain to parents about the purpose of using frejka splint or any other device.

- Educate the parents about how to use splint and keep the child hip in a position of abduction during bathing and diapering etc.