Purpose
Hip dislocation in children with cerebral palsy (CP) is a common and severe problem.
It results in significant morbidity in terms of pain,
postural difficulty,
ambulation,
disability and lower-extremity fractures.
Abnormal muscle forces and muscle imbalance around the hip are believed to be the underlying cause of hip displacement by shifting the mechanical axis of the hip (1).
Particularly hyperactivity of the hip flexors and adductors are reported as the contributing factors (2).
In 1980,
Reimers defined the migration percentage (MP) to document the extent...
Methods and Materials
Subjects
The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki and the study was approved by the local Ethics Committee and Institutional Review Board.
Written informed consent was obtained from each child’s parent.
This prospective study included 50 hips of 25 children with spastic CP. Inclusion criteria were as follows; having diagnosis of CP verified by a physiatrist who had an experience in in pediatric rehabilitation medicine,
having at least MAS 1 spasticity in the flexor and adductor hip muscles...
Results
The mean age of the study populations was 4.07± 2.25 years (range; 2-8 years).13 of the patients were female and 12 of the patients were male.
There is a moderate positive correlation between MP and the stiffness of hip flexor muscles (r=0.70,
p< .05).
There is a moderate positive correlation between MP and the stiffness of hip adductor muscles (r=0.71,
p< .05).
The correlation between the stiffness of flexor and extensors is weak (r=0.10,
p≥ .05).
There is a weak correlation between the stiffness of...
Conclusion
In this study we aimed to assess the correlation between the MP and the stiffness of the hip muscles.
We showed a moderate positive correlation between MP and the stiffness of hip flexor muscles.
Until recently,
the correlation between the MP and the stiffness of the hip muscles in children with spastic CP had not been studied,
to our knowledge.
A baseline radiographic view of the pelvis was recommended at 12–18 months,
and follow-up of these patients at 6-month intervals has been suggested (8).
If...
References
1.Kalen V,
Bleck EE.
Prevention of spastic paralytic dislocation of the hip.
Dev Med Child Neurol.
1985; 27:17–25
2.Yildiz C,
Demirkale I.
Hip problems in cerebral palsy: Screening,
diagnosis and treatment.
Curr Opin Pediatr.
2014; 26:85-92.
3.Reimers J.
The stability of the hip in children.
A radiological study of the results of muscle surgery in cerebral palsy.
Acta Orthop Scand Suppl.
1980; 184:1-100.
4.Shore B,
Spence D,
Graham H: The role for hip surveillance in children with cerebral palsy.
Curr Rev Musculoskelet Med.
2012; 5:...