Tag Archive for: Hip subluxation

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 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

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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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Lever Arm dysfunction of Hips in Cerebral Palsy

Volume 10 | Issue 1 | January-April 2024 | Page: 14-19 | Jitendra Kumar Jain

DOI- https://doi.org/10.13107/ijpo.2024.v10i01.173

Submitted: 14/01/2024; Reviewed: 10/02/2024; Accepted: 06/03/2024; Published: 10/04/2024

Authors: Jitendra Kumar Jain MS Ortho [1]

[1] Trishla Foundation, Tagore Town, Prayagraj, Uttar Pradesh, India.

Address of Correspondence

Dr. Jitendra Kumar Jain,
Chairman, Trishla Foundation, Tagore Town, Prayagraj, Uttar Pradesh, India.
E-mail: jjain999@gmail.com

Abstract

In cerebral palsy, hip dysfunction is the second most common problem after equines deformity. Abnormal skeletal development of the proximal femur due to abnormal forces in cerebral palsy leads to lever arm function by reducing the length of the lever arm contributing to one of very important causes of gait abnormality. High hip anteversion, high neck shaft angle, subluxation, and dislocation are the most common lever arm dysfunctions at the hip joint. This lever arm dysfunction increases progressively with age and correspondence to GMFCS level. If not identified at a very early stage then it may progress to completely deform the femoral head & hip joint. Early identification and preventive surgery help in preventing progression in GMFCS I to III but can progress despite of preventive surgery in non-walker children FMFCS IV & V. Recurrence of the problem is also very common in non-walker children. So we need detailed information about the lever arm problem in the hip and how to deal with this problem in cerebral palsy children. In this article, we have discussed etiology, and how to identify and management protocols for different lever arm dysfunctions of the hip in cerebral palsy.
Keywords: Cerebral palsy, Lever arm dysfunction of hip, Hip subluxation, Anteversion

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How to Cite this Article:  Jain J | Lever Arm dysfunction of Hips in Cerebral Palsy | International Journal of Paediatric Orthopaedics | January-April 2024; 10(1): 14-19 .  https://doi.org/10.13107/ijpo.2024.v10i01.173

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