{"id":11738,"date":"2021-03-25T13:26:58","date_gmt":"2021-03-25T13:26:58","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=11738"},"modified":"2023-11-27T19:35:22","modified_gmt":"2023-11-27T19:35:22","slug":"afectiunile-ortopedice-la-bebelusi-si-copii-cand-tratam-cand-asteptam","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/afectiunile-ortopedice-la-bebelusi-si-copii-cand-tratam-cand-asteptam\/","title":{"rendered":"Afectiunile ortopedice la bebelusi si copii. Cand tratam, cand asteptam?"},"content":{"rendered":"

Orice afectiune congenitala necesita tratament imediat, iar printre afectiuni congenitale se numara piciorul stramb congenital varus equin, piciorul tal valg forma severa (astragal oblic congenital), displazia de sold, luxatia si sub-luxatia de sold sau sub-luxatia de genunchi congenitala, prezenta la nou-nascut, torticolisul muscular congenital, metatarsus adductus congenital. In categoria tratamentelor imediate intra si formele posturale severe – piciorul tal valg, torticolisul postural, plagiocefalia, piciorul metatarsus adductus. Dupa cum se observa, aceeasi afectiune exista \u00een mai multe forme \u201dde agregare\u201d (forma congenitala, forma posturala severa, forma posturala medie\/usoara).<\/p>\n

Toate aceste deformari, fie ca este afectiune congenitala fie ca sunt posturale dar severe, necesita tratament imediat prin ortezare \u00eentre cateva luni si cativa ani, deoarece riscul de recidiva este destul de mare.<\/p>\n

In fapt, orice deformare rigida care nu raspunde la manevrele de corectie (sau raspunde greu), necesita tratament de ortezare si exercitii de manipulare (kinetoterapie) indiferent din ce categorie face parte. Medicul ortoped<\/a> pediatru este cel care diagnosticheaza si apreciaza starea de rigiditate a deformarii, precum si tratamentul de ortezare adecvat.<\/p>\n

De ce se face ecografia de sold \u00een primele 4-6 saptamani de viata?<\/strong><\/p>\n

A devenit limitativa aceasta recomandare, din punctul meu de vedere, pentru ca majoritatea parintilor sau a cadrelor medicale au perceput ca nu se poate face ecografia de sold \u00eenca de la nastere, adica \u00een primele 2-3 saptamani dupa nastere. Care este fundamentul acestei afirmatii de a se face \u00eentre 4-6 saptamani? In mod normal copiii se nasc cu articulatiile coxo-femurale deja maturizate, adica avand o valoare a unghiului alfa peste 68-70 de grade.\u00a0 Un alt procent al copiilor nascuti cu valori mai mici \u00eentre 60 si 68 se datoreaza pozitiei intra-uterine deficitare (fie macrosom, fie sarcina gemelara, pozitie pelviana sau o alta afectiune a uterului mamei). Acest deficit de maturizare al soldurilor, odata depistat \u00eenca de la nastere sau din primele 2 saptamani poate fi recuperat foarte repede \u00een perioada 1-6 saptamani. Din punct de vedere embriologic si fiziologic, rata de multiplicare a celulelor osoase de la nivelul cartilajului de crestere al soldului este maxima \u00een prima luna pana la 6 saptamani. Intre 6 saptamani si 3 luni aceasta rata de maturizarea a soldului scade cu 50% din potential. Dupa varsta de 3luni, capacitatea de maturizare a soldului este mai mica de 25% din potential.<\/p>\n

Este clar ca un sold depistat imatur si tratat pana \u00een varsta de o luna se recupereaza mult mai repede si complet decat un sold al carui tratament \u00eencepe dupa varsta de 6 saptamani din cauza faptului ca abia dupa varsta de 6 saptamani a fost depistat ecografic. Astfel, recomandarea mea este ca aceasta investigatie sa fie efectuata \u00een primele 2-3 saptamani dupa nastere pentru ca \u00een cazul \u00een care soldul este imatur are timp sa se recupereze complet si rapid prin aplicarea unui tratament precoce.<\/p>\n

Deformarile de picioare<\/strong><\/p>\n

In ultima perioada, \u00een cadrul centrului nostru CRON Pheonix, s-au prezentat tot mai mul\u021bi copii cu deformari ale picioarelor, de tip plat valg, tal valg, metatarsus adductus sau picior scobit carora nu li s-a spus din momentul nasterii ca ar avea aceasta deviatie si prin urmare, se confrunta la varste mari cu aceasta situatie greu de manageriat. Cele mai bune corectii se obtin prin aplicarea tratamentului (orteza si kinetoterapie) cu cateva luni \u00eenainte de varsta mersului pentru a permite deviatiilor osoase si deficitelor musculare sa se regleze. Odata ce copilul s-a ridicat \u00een picioare cu aceste deviatii prezente, ele se vor accentua odata cu cresterea, nicidecum nu au capacitatea de auto-vindecare asa cum sunt informati parintii care observa prezenta deviatiilor dar sunt \u00eendrumati sa astepte. Un reper important \u00een urmarirea acestor deviatii este timpul – daca \u00een interval de un an nu s-a produs nicio corectie totala sau partiala iar deformarea se mentine sau se accentueaza pe masura ce copilul creste este clar ca trebuie sa lasam deoparte speranta ca se va vindeca de la sine si sa actionam cat mai curand aplicand tratamentul adecvat.<\/strong><\/p>\n

\"\"<\/a><\/p>\n

Plagiocefalia<\/strong><\/p>\n

O alta deformare neglijata de la nastere sau \u00een perioada de sugar este plagiocefalia. Formele medii si severe necesita tratament imediat prin anumite tehnici de recuperare (osteopatie craniana, tehnici miotensive, posturari). Formele usoare necesita si ele urmarirea atenta deoarece se pot transforma si ele \u00een plagiocefalii severe \u00een cazul \u00een care de la nastere se asociaza un torticolis muscular care va \u00eempiedica copilul sa pozitioneze capul pe ambele parti. Medicul ortoped<\/a> pediatru va stabili gradul de deformare prin masurarea craniului cu craniometru si prin verificarea asocierii, sau nu, cu alte contracturi musculare, care pot agrava o simpla plagiocefalie.<\/p>\n

Orice deformare prezenta de la nastere sau dobandita pe parcursul cresterii necesita o urmarire atenta pana la 18 ani, deoarece copiii au pusee de crestere care evidentiaza orice mic dezechilibru prezent la nivelul scheletului, la nivel muscular si articular.<\/p>\n

Doctor Valentina Contanu<\/strong><\/p>\n

Medic Specialist Ortopedie Pediatrica<\/strong><\/p>\n

Centrul de Reabilitare Ortopedica si Neurologica Phoenix<\/p>\n

https:\/\/www.cron-phoenix.ro\/<\/a><\/p>\n

contact@cron-phoenix.ro<\/a><\/p>\n

0721 863 958\/0721 567 186<\/p>\n","protected":false},"excerpt":{"rendered":"

Orice afectiune congenitala necesita tratament imediat, iar printre afectiuni congenitale se numara piciorul stramb congenital varus equin, piciorul tal valg forma severa (astragal oblic congenital), displazia de sold, luxatia si […]<\/p>\n","protected":false},"author":6,"featured_media":11740,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[1082,89,752,363],"tags":[767,766,768,769,765,753,759,756,757,646,760,762,764,754,758,755,761,763],"class_list":["post-11738","post","type-post","status-publish","format-standard","has-post-thumbnail","category-featured","category-medicina-de-familie","category-ortopedie","category-reabilitare-medicala","tag-afectiuni-ortopedice","tag-astragal-oblic","tag-bebelusi","tag-copii","tag-cron-phoenix","tag-deformari-de-picioare","tag-displazia-de-sold","tag-ecografia-de-sold","tag-equin","tag-kinetoterapie","tag-luxatia","tag-metatarsus-adductus","tag-phoenix","tag-picior-scobit","tag-piciorul-tal-valg","tag-plagiocefalia","tag-torticolisul","tag-torticolisul-postural"],"yoast_head":"\nDe ce se face ecografia de sold \u00een primele 4-6 saptamani de viata?<\/title>\n<meta name=\"description\" content=\"Orice afectiune congenitala necesita tratament imediat prin ortezare \u00eentre cateva luni si cativa ani, deoarece riscul de recidiva este destul de mare\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/afectiunile-ortopedice-la-bebelusi-si-copii-cand-tratam-cand-asteptam\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"De ce se face ecografia de sold \u00een primele 4-6 saptamani de viata?\" \/>\n<meta property=\"og:description\" content=\"Orice afectiune congenitala necesita tratament imediat prin ortezare \u00eentre cateva luni si cativa ani, deoarece riscul de recidiva este destul de mare\" \/>\n<meta property=\"og:url\" content=\"https:\/\/jurmed.ro\/medici\/afectiunile-ortopedice-la-bebelusi-si-copii-cand-tratam-cand-asteptam\/\" \/>\n<meta property=\"og:site_name\" content=\"Jurmed - Medici\" \/>\n<meta property=\"article:published_time\" content=\"2021-03-25T13:26:58+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-11-27T19:35:22+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2021\/03\/logo-Cron-Pheonix-1.png\" \/>\n\t<meta property=\"og:image:width\" content=\"300\" \/>\n\t<meta property=\"og:image:height\" content=\"201\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"costelv\" \/>\n<meta name=\"twitter:label1\" content=\"Scris de\" \/>\n\t<meta name=\"twitter:data1\" content=\"costelv\" \/>\n\t<meta name=\"twitter:label2\" content=\"Timp estimat pentru citire\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/jurmed.ro\/medici\/afectiunile-ortopedice-la-bebelusi-si-copii-cand-tratam-cand-asteptam\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/jurmed.ro\/medici\/afectiunile-ortopedice-la-bebelusi-si-copii-cand-tratam-cand-asteptam\/\"},\"author\":{\"name\":\"costelv\",\"@id\":\"https:\/\/jurmed.ro\/medici\/#\/schema\/person\/d32bd0fe3243bb12082045e5e5635d2d\"},\"headline\":\"Afectiunile ortopedice la bebelusi si copii. 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