Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience
DOI:
https://doi.org/10.25759/spmfr.333Keywords:
Cerebral Palsy/complications, Child, Hip, Hip Dislocation/prevention & control, Risk AssessmentAbstract
Introduction: Our objective was to characterize patients under 18 years old with cerebral palsy (CP), followed in our center, regarding their clinical and functional characterization and the presence of hip deformities, as well as surgical orientations.
Material and Methods: Retrospective cross-sectional study based on the files of patients with CP, clinical registers, and serial radiological evaluation of hips according to the Australian Hip Surveillance Program (HSP). Analysis of the group with functional classifications IV and V and characterization of hip deformities: radiological evaluation of the femoral migration index (MI). Subanalysis of patients submitted to orthopedic surgery and patients not submitted to any surgery. The presentation of the results was divided into age groups (1-5 years; 6 – 11 years; 12-18years), according to the coverage of the HSP implemented, in 2012, at our center.
Results: Of the total of 285 children with PC, the group with functional levels IV and V had 88 patients. From these group, more than half had subluxation of the hip. Were excluded 30 children. The total non-operated children was 35, the mean MI was 31.6%. The age group of 1-5 years had 3 patients, with a MI of 33.5% and the mean of the last hip radiograph was 7.1 months. The group of 6-11 years had 13 patients, with MI of 32.2%, and the mean of the last radiograph was 11.6 months. The 12-18 years group had 19 patients with a MI of 30.9% and the mean of the last radiograph was 24.5 months. The total operated patients was 23. From these group, 4 were operated before the implementation of the hip surveillance program. After 2012, 19 patients were operated. From these group, 6 were operated with preventive tenotomies and mean of 5 years.
Conclusion: About half of the patients with IV and V functional levels had subluxation of the hip. About 38% of these patients have already submitted to surgery. From these group, 1/3 were tenotomies with early ages. Patients who are not surgically treated are under hip surveillance. In this population there is a high prevalence of this hip deformity. However, articulation with orthopedics has allowed early surgical interventions.
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