Hip displacement in children with cerebral palsy in Scotland: A total population study

Abstract Purpose The purpose of this study is to report the number of children from a total population of children with cerebral palsy (CP) in Scotland who had a displaced or dislocated hip at first registration in a national surveillance programme. Methods Migration percentage (MP), laterality, Gro...

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Bibliographic Details
Published in:Journal of children's orthopaedics 2018-12, Vol.12 (6), p.635-639
Main Authors: Bugler, K. E., Gaston, M. S., Robb, J. E.
Format: Article
Language:English
Subjects:
Age
Cerebral palsy
Classification
Confidence intervals
Hip dislocation
Hip joint
Original Clinical
Orthopedics
Pediatrics
Population
Radiography
Registration
Surgeons
Surveillance
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Summary:Abstract Purpose The purpose of this study is to report the number of children from a total population of children with cerebral palsy (CP) in Scotland who had a displaced or dislocated hip at first registration in a national surveillance programme. Methods Migration percentage (MP), laterality, Gross Motor Function Classification System (GMFCS) level, CP subtype, distribution of CP and age were analyzed in 1171 children. Relative risk was calculated with 95% confidence intervals. Hip displacement and dislocation were defined as a MP of 40 to 99 and > 100 respectively. Results Radiographs were available from the first assessment of 1171 children out of 1933 children registered on the system. In all, 2.5% of children had either one or both hips dislocated (29/1171) and dislocation only occurred in children of GMFCS levels IV and V. A total of 10% of children had a MP 40 to 99 in one or both hips (117/1171). An increasing GMFCS level was strongly associated with an abnormal MP. Hip dislocation was unusual in patients under the age of seven years. A MP of 40 to 99 was not seen in children with isolated dystonia. Displacement was more frequent in children with bilateral involvement and dislocation was only seen in spastic and mixed tone groups. Conclusion This data gives an overview of the number of CP children who have hip displacement/dislocation in Scotland and who will possibly require surgery. Level of Evidence I
ISSN:1863-2521
1863-2548
DOI:10.1302/1863-2548.12.180106