Hip Displacement in Cerebral Palsy
Original Editor - Your name will be added here if you created the original content for this page.
Lead Editors
Introduction
[edit | edit source]
Hip displacement is very common in children with cerebral palsy (CP) and the incidence has been reported to be 35%[1][2]. It is directly related to the child’s Gross Motor Function Classification Scale (GMFCS) level with a reported incidence of between 68-90% for children in GMFCS Level IV and V[1][3]. Progressive hip displacement can cause severe pain. In a recent study examining hip health at skeletal maturity in 98 young adults with CP, hip pain was reported in 72% of participants and pain frequency and severity increased with worsening hip morphology[4]. It can also lead to difficulties with positioning, sitting, standing and walking and negatively impact quality of life[5][6][7]
Mechanism of Injury / Pathological Process
[edit | edit source]
Muscular imbalance around the hip has been proposed as one possible cause of the lateral displacement. Yildiz et al (2014) suggest that hyperactivity of the hip flexors and adductors are contributing factors[8]. In addition the combination of femoral neck-shaft angle and femoral anteversion contributes to the risk of hip displacement[7]. A clear relationship between GMFCS level and hip displacement has been established. Children with greater functional loss (GMFCS levels IV and V) are at a highest risk[1][3][9][10]. Age is also a factor. Hagglund et al (2007) reported that the most common age of displacement in their population was 3-4 years and some were as young as 2 years9. Progression of hip displacement has also been reported after puberty and progression and dislocation has occurred after skeletal maturity, the latter happening in the presence of scoliosis and pelvic obliquity[10]. It appears that topography and movement disorder are poor predictors of hip subluxation[10].
Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition
Diagnostic Procedures[edit | edit source]
add text here relating to diagnostic tests for the condition
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Management / Interventions
[edit | edit source]
add text here relating to management approaches to the condition
Differential Diagnosis
[edit | edit source]
add text here relating to the differential diagnosis of this condition
Key Evidence[edit | edit source]
add text here relating to key evidence with regards to any of the above headings
Resources
[edit | edit source]
add appropriate resources here
Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
Recent Related Research (from Pubmed)[edit | edit source]
Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ 1.0 1.1 1.2 Soo B, Howard J, Boyd R, et al. Hip displacement in cerebral palsy. J Bone Joint Surg Am. 2006;88(1):121-129
- ↑ Novak I, Hines M, Goldsmith S, Barclay R. Clinical prognostic messages from a systematic review on cerebral palsy. Pediatrics. 2012;130(5):e1285-e1312.
- ↑ 3.0 3.1 Terjesen T. The natural history of hip development in cerebral palsy. Dev Med Child Neurol. 2012;54(10):951-957.
- ↑ Wawrzuta J, Willoughby K, Molesworth C, et al. Hip health at skeletal maturity: A population-based study of young adults with cerebral palsy. Dev Med Child Neurol. 2016.
- ↑ Hägglund G, Andersson S, Düppe H, Lauge Pedersen H, Nordmark E, Westbom L. Prevention of dislocation of the hip in children with cerebral palsy. the first ten years of a population-based prevention programme. J Bone Joint Surg Br. 2005;87(1):95-101.
- ↑ Robb JE, Hägglund G. Hip surveillance and management of the displaced hip in cerebral palsy. J Child Orthop. 2013;7(5):407-413.
- ↑ 7.0 7.1 Shore B, Spence D, Graham H. The role for hip surveillance in children with cerebral palsy. Curr Rev Musculoskelet Med. 2012;5(2):126-134.
- ↑ Yildiz C, Demirkale I. Hip problems in cerebral palsy: Screening, diagnosis and treatment. Curr Opin Pediatr. 2014;26(1):85-92.
- ↑ Hägglund G. Characteristics of children with hip displacement in cerebral palsy. BMC musculoskeletal disorders. 2007;8:101-101.
- ↑ 10.0 10.1 10.2 Wynter M, Gibson N, Willoughby K, et al. Australian hip surveillance guidelines for children with cerebral palsy: 5-year review. Dev Med Child Neurol. 2015;57(9):808-820.
