Electrophoresis with calcium ions, used on the hip joint area for dysplasia, is recognized as an effective treatment method. To obtain a lasting effect, repeated courses of treatment will be required. The procedure does not present any technical difficulties; if the device is available, it is possible to treat hip joints at home.
Electrophoresis for dysplasia is positively combined with paraffin applications and therapeutic exercises. Along with calcium supplements, it is recommended to take vitamin D courses, prescribe nicotinic acid and drugs that relieve muscle hypertonicity. The therapeutic effect of physiotherapy is not achieved immediately; treatment is meant to be long-term and regular.
Operating principle of the electrophoresis apparatus
The introduction of calcium ions by electrophoretic method into the area of the hip joints is carried out using a number of devices. A device called “Flow” is in demand and popular among devices. It has two inlets for connecting electrodes: under the plus and minus signs. The button panel is designed to adjust the exposure time. New analogues are equipped with indicators that reflect the exposure and current intensity set by the health worker.
Treatment with electrophoresis is allowed only with the permission of the attending physician!
A special gasket is placed on the electrode. As a rule, they use a special hydrophilic fabric or gauze folded in several layers. The gauze is wrapped in filter paper.
Electrophoresis apparatus
Before the procedure, you need to prepare a solution. Calcium preparations are dissolved in physiological solution. The prepared solution is heated to body temperature. The finished preparation (gluconate or calcium chloride) is drawn into a syringe and the gasket is moistened. The gasket is connected to the positive pole. Saline solution or aminophylline is poured onto the gasket that is connected to the minus. The drug increases blood circulation and has an antispasmodic effect.
Under the influence of a weak electric current, electrolysis of a medicinal substance containing calcium occurs. As a result, charged particles of the substance are formed that penetrate through the skin into the hip joint area. Most of the drug has a local effect on the tissue of the hip joints. A certain amount of the medicine is absorbed into the bloodstream and lymphatic fluid and transported throughout the body.
Calcium ions penetrate into the hip joint area through the skin along the following routes:
- Through the ducts of the sebaceous and sweat glands;
- Hair follicles;
- Intercellular space.
Material and methods
The prevalence and structure of hip joint pathology were studied in 12 thousand children (6390 girls, 5610 boys) aged 0 to 5 years (average age 2.0±0.41 years) based on visits to an orthopedist in the clinic for the period from 2009 to 2015 All children underwent a standard clinical orthopedic examination and assessment of somatic status at the appointment. Diagnosis of immaturity and dysplasia of the hip joint in children under 1 year of age was performed using ultrasound (using devices and PHILIPS HD3) and X-ray examination in direct projection and with internal rotation (using the device).
The results of long-term observations of children with identified hip joint pathology that had not resolved by the age of 1 year, with a separate analysis of the effectiveness of treatment of this pathology in the early stages, were documented in outpatient (form No. 25/u-04) and control (form No. 30) cards, as well as in specially developed protocols indicating the stages of observations and conclusions at each of them.
The study was performed in accordance with the standards of good clinical practice and the requirements of the World Medical Association Declaration of Helsinki (2008). The study protocol was approved by the local ethics committee. Before inclusion in the study, written informed consent and permission to publish clinical cases were obtained from all parents of participating children.
Observation of newborns was carried out according to the developed algorithm in several stages.
At the first stage, at the age of 1 month, clinical examination data were purposefully assessed (asymmetry of skin folds on the thigh, degree of limitation of extension or increase in the range of passive movements in the hip joint, relative shortening of the lower limb). At the same age, the first ultrasound of the hip joint was performed.
The need for an active second stage (children aged 3–4 months) was determined by the presence of articular pathology identified at the first stage of observation. At the same time, the data of the clinical examination and repeated ultrasound of the hip joint were again assessed.
All children were included in the third stage of the examination (6 months). For children without hip joint pathology, examination at the age of six months was mandatory due to the need to ascertain the presence of ossification nuclei of the femoral heads with an assessment of their size, mono- or multicentricity. Children with previously established pathology of the hip joint, which could not be corrected by 6 months, underwent an X-ray examination. At the same age, systemic manifestations of undifferentiated connective tissue dysplasia were assessed, including external dysmorphogenetic signs, neurological disorders, ectodermal, valvular and vascular syndromes, generalized hypermobility, and other somatic concomitant pathologies. In addition, combined orthopedic pathology was taken into account in accordance with existing recommendations [9, 13].
Statistical processing of the obtained data was carried out using the BIOSTAT 4.0 program. Quantitative data with a normal distribution are presented as the mean and standard error ( M ± m
).
How is the procedure performed?
Before treating hip joints using electrophoresis, you will need to obtain a prescription from your attending physician and exclude contraindications to the procedure. A trained nurse carefully examines the surface of the child’s skin at the sites where the electrode plates are applied. There should be no pustular rashes, papillomas, or moles on the skin.
Treatment procedure
The pads are installed on the hip joint area; it is necessary to fix the electrodes on the front and back areas of the child’s hip joint. The electrode with a red cord (anode) is wrapped in a gasket with a medicinal substance. The cathode is wrapped in a gasket containing saline solution or clean warm water. It should be secured on top with a towel or diaper so that the child does not accidentally move the electrodes. For older children, small sandbags are used.
The device turns on, the current slowly increases until the patient experiences a sensation of “goosebumps” or slight tingling under the electrodes. The sensations should not be excessive or cause discomfort. An infant will not tell you when he begins to feel tingling sensations; for babies, the current strength is set to within 5 mA. The ideal option would be to pre-test the mother on the skin of the medial surface of the elbow or shoulder, where the skin is especially thin and sensitive. An experienced worker is called upon to supervise the procedure. It is gradually possible to carry out treatment at home using a portable electrophoresis machine. A number of types of equipment are known; the Potok device has remained popular for many years.
The procedure takes 5–10 minutes for children, depending on age. The duration of treatment for hip dysplasia will be 10–20 procedures. Courses can be repeated several times a year depending on the patient’s condition.
An alternative way of carrying out the electrophoresis procedure is described - using a bath into which a solution of a medicinal substance is poured, the diseased area is immersed inside. A weak electric current is passed through the solution.
Electrical treatment through a bath
Description of the procedure and its advantages
Thanks to electrophoresis, medications are administered to the baby in liquid form, and they go directly to the diseased organ. For children, a minimum current discharge is established so as not to worsen the child’s condition. An electrophoresis apparatus consists of a device and metal plates through which current discharges are applied. Metal plates are attached to a certain part of the body, an electric current is supplied through them, and medications penetrate the body to the organ that needs it.
What affects the quality of the procedure
The effectiveness of the electrophoresis procedure depends on how effectively the calcium preparation is absorbed into the tissue of the hip joints. The factor is directly influenced by the following circumstances:
- Patient's age. The younger the child, the more active the blood circulation and the better the absorption through the surface of the skin.
- Place of impact. The skin on different parts of the body has different electrical resistance and ability to absorb calcium ions.
- Calcium dosage and concentration. A solution of calcium gluconate or calcium chloride is preferably used, having an initial concentration of 10%; during the electrophoresis procedure, the drug is diluted several times with distilled water.
- Electric current strength. It is important to avoid feeling pain and burning when the current is too high.
- Ion size and charge. Calcium and chlorine ions are well absorbed.
- Individual reaction to the drug.
Properties of calcium ions
According to scientific and clinical studies, particles with different charges have different effects on the affected tissue.
Calcium ions
Calcium ions carrying a positive charge have therapeutic effects:
- Anti-inflammatory effect.
- Analgesic effect in pain syndrome.
- Relieving swelling and calming.
- Direct absorption into joint tissue allows calcium to strengthen the structure of cartilage and bone tissue, promote reparative functions and further normal growth and development.
- Hemostatic effect.
- Antihistamine and antiallergic.
Electrophoresis with ionized calcium is used for a number of diseases accompanied by a deficiency of the element in the body. This includes hip dysplasia in children.
Therapeutic properties of electrophoresis
The electrophoresis procedure involves the described effect on body tissue:
- Relieves the inflammatory process during complications of hip dysplasia such as coxarthrosis or chondrosis of the joint.
- Reduces swelling in the presence of severe congenital dislocations.
- Eliminates painful sensations.
- Eliminates hypertonicity of the muscles of the thigh and buttocks.
- Improves microcirculation in joint tissues.
- Stimulates the regenerative functions of joint tissues.
Electrophoresis with calcium has established itself as a worthy alternative in the conservative treatment of children in the first months of life, when other routes of drug administration are difficult.
When is electrophoresis needed?
The method affects the human body as follows:
- relaxes muscles;
- relieves spasms;
- reduces inflammatory processes;
- relieves pain in the joints.
Therefore, electrophoresis using drugs for the lower extremities of infants is prescribed if:
- lesions of the musculoskeletal system, pelvic joint dysplasia;
- unpleasant sensations accompanying a particular disease;
- neuralgia of the legs: hyper- and hypotonicity, birth injuries.
Advantages of the calcium ion electrophoresis method
When comparing the treatment method with similar ones, it can be unequivocally stated that the method has a number of advantages:
- The introduction of calcium ions using electrophoresis does not have toxic effects or side effects on the body, unlike, for example, the injection method.
- When calcium is administered by electrophoresis, its therapeutic effect lasts much longer compared to other methods.
- In addition to calcium, it is permissible to administer additional drugs: aminophylline, nicotinic acid.
- When performing electrophoresis, calcium ions are deposited in bone and cartilage tissue; they are retained in the tissues for three weeks. This makes the treatment process gentle and gradual, which is what infants require.
- The tissues of the thigh and hip joint become sensitive under the influence of a weak electric current, which makes it possible to carry out therapeutic effects on the joints using minimal concentrations of drugs.
- The introduction of calcium ions is carried out directly into the focus of the affected tissue, bypassing the digestive tract, avoiding the destruction of a significant part of the substance in the intestines.
- Electrophoresis does not have a destructive effect on body tissues.
Electrophoresis with drugs
The solution is prepared immediately before starting. The doctor determines the required concentration based on the diagnosis and specific indications.
To obtain the required percentage of the active substance, use distilled water, alcohol or dimexide.
According to Ratner
The method developed by the scientist involves the simultaneous use of 2 drugs:
- Eufillin;
- Papaverine.
The first one serves for:
- vasodilation;
- improving blood flow in joints;
- eliminating local muscle tension;
- blood clot splitting;
- improving cardiac and respiratory activity.
Papaverine is known for its ability to quickly and effectively relieve muscle tension and relieve pain.
Together they successfully cope with the following problems:
- birth injuries;
- pathologies in the circulatory system of the cervical spine;
- Cerebral palsy.
Euphellin is used in the form of a 5% solution, and Papaverine - 1%. The procedure takes 15 minutes.
This method is prescribed to infants if they have:
- pelvic dysplasia;
- increased ICP and malfunction of cerebral vessels;
- inflammation in the joints;
- Hypo- or hypertonicity.
Contraindications to the use of electrophoresis
Undoubtedly, electrophoresis with calcium has many advantages over other therapeutic techniques. When performing electrophoresis, one cannot fail to take into account that the procedure reveals a number of contraindications for use:
- Presence of cancer.
- For young children suffering from various types of diathesis.
- The presence of an acute inflammatory or purulent process in the body.
- With an increased tendency to vascular bleeding.
- Individual intolerance to galvanic effects or calcium preparations.
If there are abrasions and cuts on the surface of the skin where the electrodes are applied, it is better to avoid the procedure for a while. In exceptional cases, it is possible to lubricate the affected area with Vaseline and cover it with a piece of wax paper.
Danger for babies
Electrophoresis is applicable as a treatment method even for infants. If there are no serious diseases and specific indications, doctors prefer it over drug therapy. But, as with any external influence on the body (especially infants), there are a number of contraindications:
- electrophoresis is strictly prohibited if the baby has purulent skin infections or dermatitis, since the procedure itself is associated with a direct effect on the external integument;
- at elevated body temperature, an electrical discharge will aggravate the problem;
- bronchial asthma with relapses is also a contraindication;
- renal and heart failure force specialists to abandon this relatively safe method of treatment;
- allergies to additional medications and intolerance to current discharges make electrophoresis impossible.
During the procedure, it is normal if at first the baby feels a little uncomfortable with cold wipes soaked in medicinal liquid, and if he feels a slight tingling in the affected areas.