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Hip Displacement in Children with Cerebral Palsy- A Clinico- Radiological Evaluation

Volume 10 | Issue 3 | September-December 2024 | Page: 6-11 | Deepa Metgud, Shruti Desai, Shreya Bavi, Vinuta Deshpande, Naveenkumar Patil, Santosh Patil DOI- https://doi.org/10.13107/ijpo.2024.v10.i03.200 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2024; The Author(s). Submitted: 20/11/2024; Reviewed: 26/11/2024; Accepted: 08/12/2024; Published: 10/12/2024 Authors: Deepa Metgud PhD, MPT [1], Shruti Desai […]

Outcomes in Paediatric Proximal Third Forearm Fractures: A Systematic Review

Volume 10 | Issue 3 | September-December 2024 | Page: 2-5 | Nathan McKenzie, Connor Zale, Ryan Nguyen, Kevin Krul DOI- https://doi.org/10.13107/ijpo.2024.v10.i03.198 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2024; The Author(s). Submitted: 14/11/2024; Reviewed: 20/11/2024; Accepted: 04/12/2024; Published: 10/12/2024 Authors: Nathan McKenzie B.S. [2], Connor Zale M.D. [1], Ryan Nguyen B.S. […]

Hip Displacement in Children with Cerebral Palsy- A Clinico- Radiological Evaluation

Outcomes in Paediatric Proximal Third Forearm Fractures: A Systematic Review

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Hip Displacement in Children with Cerebral Palsy- A Clinico- Radiological Evaluation

Volume 10 | Issue 3 | September-December 2024 | Page: 6-11 | Deepa Metgud, Shruti Desai, Shreya Bavi, Vinuta Deshpande, Naveenkumar Patil, Santosh Patil

DOI- https://doi.org/10.13107/ijpo.2024.v10.i03.200

Open Access License: CC BY-NC 4.0

Submitted: 20/11/2024; Reviewed: 26/11/2024; Accepted: 08/12/2024; Published: 10/12/2024

Authors: Deepa Metgud PhD, MPT [1], Shruti Desai MPT [1], Shreya Bavi MPT [1], Vinuta Deshpande MPT [1], Naveenkumar Patil MS Ortho [2], Santosh Patil MD Rad [3]

[1] Department of Paediatric Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India.
[2] Department of Orthopaedics, KAHER’S JGMM Medical College Gabbur, Kotagondhunshi, Hubbali, Karnataka, India.
[3] Department of Radiology, JN Medical College, Belagavi, Karnataka, India.

Address of Correspondence

Dr. Deepa Metgud
Department of Paediatric Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India.
Email Id: deepametgud@klekipt.edu.in

Abstract

Background: Children with cerebral palsy (CP) are at risk for hip subluxation due to the spasticity and contractures of the hip adductors, medial hamstrings, and hip flexors. Hip displacement is often asymptomatic in these children until the hip is particularly or fully dislocated resulting in pain, gait disturbances and impaired sitting balance. Hip surveillance is a process of actively monitoring a child for early identification of hip displacement. In India, the National Hip Surveillance Program was established to support surveillance in preventing dislocations and reducing the need for surgery. In light of this, the present study aims to determine the prevalence of hip displacement in children with cerebral palsy in Belagavi.
Method: This descriptive, cross-sectional observational study was conducted at a tertiary care hospital and inclusive education schools. Children aged 2–18 years with cerebral palsy, underwent clinical examinations followed by radiographic evaluation and the Migration Percentage (MP) was calculated to categorize hip displacement, the primary outcome measure of the study. Prevalence of subluxation and its association with gender, age, GMFCS E&R levels and CP subtypes were assessed.
Results: Out of 128 children with CP assessed, 104 had subluxation, with the majority (73.44%) showing bilateral involvement, while 7.81% had right-sided subluxation. The prevalence of subluxation varied by CP subtypes, with spastic type accounting for the higher prevalence. A statistically significant association between CP subtype and subluxation was found on the right side (p = 0.003).
Conclusion: The study identifies an 81.3% occurrence of hip subluxation in children with CP, with bilateral involvement being the most prevalent (73.44%). The likelihood of subluxation was notably impacted by CP subtype, especially in spastic CP. Timely detection through clinical assessment and radiographic monitoring is vital to prevent advancement to dislocation. Future investigations should prioritize extended follow-ups and therapeutic approaches to optimize outcomes.
Keywords: Hip subluxation, Cerebral palsy, Radiography, Migration percentage

References

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How to Cite this Article: Metgud D, Desai S, Bavi S, Deshpande V, Patil N, Patil S | Hip Displacement in Children with Cerebral Palsy – A Clinico- Radiological Evaluation | International Journal of Paediatric Orthopaedics | September-December 2024; 10(3): 6-11.

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Outcomes in Paediatric Proximal Third Forearm Fractures: A Systematic Review

Volume 10 | Issue 3 | September-December 2024 | Page: 2-5 | Nathan McKenzie, Connor Zale, Ryan Nguyen, Kevin Krul

DOI- https://doi.org/10.13107/ijpo.2024.v10.i03.198

Open Access License: CC BY-NC 4.0

Submitted: 14/11/2024; Reviewed: 20/11/2024; Accepted: 04/12/2024; Published: 10/12/2024

Authors: Nathan McKenzie B.S. [2], Connor Zale M.D. [1], Ryan Nguyen B.S. [3], Kevin Krul M.D. [1]

[1] Tripler Army Medical Center. 1 Jarrett White Rd. Medical Center. Honolulu, HI. 96859.
[2] University of Oklahoma College of Medicine. 800 Stanton L Young Blvd. Oklahoma City, OK. 73117.
[3] John A. Burns School of Medicine. University of Hawaii. 651 lalo St, Honolulu, HI 96813.

Address of Correspondence

Dr. Connor Zale,
Tripler Army Medical Center. 1 Jarrett White Rd. Medical Center. Honolulu, HI. 96859.
Email: Connor.zale11@gmail.com

Abstract

Objective: To analyze initial treatment failure, functional and radiographic outcomes following non-operative management of Paediatric third proximal forearm fractures.
Methods: A search was performed on PUBMED/MEDLINE, Cochrane Database and Embase on 28 January 2024. Search keywords were “Paediatric, proximal, forearm and fracture”. Articles were reviewed for non-operative management of proximal forearm fractures. Articles were reviewed for acceptable angulation for successful treatment, rate of conversion to operative management or remanipulation, functional outcomes and final radiographic angulation.
Results: 181 articles were obtained from a literature search. 10 articles had incomplete data. 10 articles reported the rate for initial treatment failure. 4 articles reported individual patient functional outcomes. 3 articles reported individual residual angulation.
There were 392 cases of proximal forearm fractures. The rate of initial treatment failure which required remanipulation or surgery ranged from 0-83.8%. Individual functional outcomes were reported for 22 patients. The average age was 10.93.9 years old. 16/22 cases had full range of motion. The 6 cases with limited range of motion had residual angulation of 5-15 (11.54.2). 3/5 cases with 15 of residual angulation had full range of motion.
Conclusion: The rate of initial non-operative treatment failure ranged from 0-83.8% for proximal forearm fractures. Families should be advised on the high rate of failure for initial non-operative management and the possible need for remanipulation or surgery. Patients that are 10 years and older are at an increased risk for loss of reduction and possible need for surgical treatment.
Keywords: Both bone, Proximal third forearm, Paediatric forearm fracture

References

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8. Lyman A, Wenger D, Landin L (2016) Paediatric diaphyseal forearm fractures: epidemiology and treatment in an urban population during a 10-year period, with special attention to titanium elastic nailing and its complications. J Paediatr Orthop B 25:439–446. https://doi.org/10.1097/BPB.0000000000000278
9. Neal KM, Osterbur TA, Kiebzak GM (2020) Improving Quality in the Treatment of Paediatric Forearm Fractures: Minimizing the Need for Repeat Intervention With Long-arm Extension Casting. J Paediatr Orthop 40:329–333. https://doi.org/10.1097/BPO.0000000000001519
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12. Williams K, Whyte N, Carl JR, et al (2023) Predictors for operative treatment in Paediatric proximal third both-bone diaphyseal forearm fractures in children include age and translation, but not initial angulation. J Child Orthop 17:156–163. https://doi.org/10.1177/18632521231156941
13. Seefried S, Chin-Goh K, Sahakian V, et al (2022) Paediatric forearm fractures manipulated in the emergency department: incidence and risk factors for re-manipulation under general anaesthesia. N Z Med J 135:60–66. https://doi.org/10.26635/6965.5665

How to Cite this Article: McKenzie N, Zale C, Nguyen R, Krul K Outcomes in Paediatric Proximal Third Forearm Fractures: A Systematic Review | International Journal of Paediatric Orthopaedics | September-December 2024;10(3):2-5.

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