دورية
Hip displacement in children with cerebral palsy
العنوان: | Hip displacement in children with cerebral palsy |
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المؤلفون: | Wordie, Sarah J., Bugler, Kate E., Bessell, Paul R., Robb, James E., Gaston, Mark S. |
المصدر: | The Bone & Joint Journal; February 2021, Vol. 103 Issue: 2 p411-414, 4p |
مستخلص: | AimsThe migration percentage (MP) is one criterion used for surgery in dislocated or displaced hips in children with cerebral palsy (CP). The MP at which a displaced hip can no longer return to normal is unclear. The aim of this paper was to identify the point of no return of the MP through a large population-based study.MethodsAll children registered on the Cerebral Palsy Integrated Pathway Scotland surveillance programme undergo regular pelvic radiographs. Any child who had a MP measuring over 35% since the programme’s inception in 2013, in at least one hip and at one timepoint, was identified. The national radiography database was then interrogated to identify all pelvic radiographs for each of these children from birth through to the date of analysis. A minimum of a further two available radiographs following the initial measurement of MP ≥ 35% was required for inclusion.ResultsA total of 239 children (346 hips) were identified as suitable for analysis at a mean of 6.5 years (2.0 to 14.8) follow-up. In all, 1,485 radiographs taken both prior to and after a hip had a MP ≥ 35% were examined and the MP measured to identify any progression of displacement. Interrogation of the data identified that hips with a MP up to 46% returned to a MP below 40% without intervention, and all hips with a MP equal to or greater than 46% displaced further and the MP did not return to the normal range. Statistical analysis showed the result to be 98% specific with this degree of certainty that hips reaching a MP ≥ 46% would not spontaneously regress.ConclusionThese findings are clinically relevant in showing that it may be reasonable to continue to monitor hips with a MP not exceeding 46%. This threshold will also guide referral for further management of a displacing hip.Cite this article: Bone Joint J2021;103-B(2):411–414. |
قاعدة البيانات: | Supplemental Index |
تدمد: | 20494394 20494408 |
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DOI: | 10.1302/0301-620X.103B2.BJJ-2020-1528.R1 |