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Hip displacement in relation to age and gross motor function in children with cerebral palsy
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- Larnert, Per (author)
- Linköping University
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- Risto, Olof (author)
- Linköping University
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- Hägglund, Gunnar (author)
- Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Reumatologi och molekylär skelettbiologi,Institutionen för kliniska vetenskaper, Lund,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Rheumatology,Department of Clinical Sciences, Lund,Swedish National Competence Centre for Musculoskeletal Disorders
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- (creator_code:org_t)
- 2014-03-01
- 2014
- English 6 s.
- In: Journal of Children's Orthopaedics. - : SAGE Publications. - 1863-2521 .- 1863-2548. ; 8:2, s. 129-134
- Journal article (peer-reviewed)
Abstract
Subject headings
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- Purpose: Hip dislocation in cerebral palsy (CP) is a serious complication. By radiographic screening and prophylactic surgery of children at risk most dislocations can be prevented. CPUP, the Swedish CP registry and follow-up program, includes annual radiographic examinations of children at Gross Motor Function Classification System (GMFCS) levels III-V. Data from CPUP were analysed to assess the risk of hip displacement in relation to GMFCS levels and age. Methods: All children at GMFCS levels III-V (N = 353) whose first radiographic screening occurred before 3 years of age were followed between the ages 2-7 years. Migration percentages (MPs) were recorded annually (1,664 pelvic radiographs) and analysed using discrete time survival analysis. Results: The risk of hip displacement between 2 years and 7 years of age was significantly (p < 0.05) higher for children at GMFCS level V during the entire study period. The risk was highest at 2-3 years of age and decreased significantly (p < 0.001) with each year of age (OR = 0.71, 95 % CI 0.60-0.83). The cumulative risk at age 7 years for those at GMFCS V for MP ≥ 40 % was 47 % (95 % CI 37-58). The corresponding risk at GMFCS IV was 24 % (16-34) and at GMFCS III 23 % (12-42). Conclusions: Children at GMFCS V have a significantly higher risk of hip displacement compared with children at GMFCS III-IV. The risk is highest at 2-3 years of age. The results support a surveillance program including radiographic hip examinations as soon as the diagnosis of severe CP is suspected.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- Cerebral palsy
- CP
- Hip dislocation
- Hip displacement
- Hip surveillance
Publication and Content Type
- art (subject category)
- ref (subject category)
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