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Untreated hip dislocation in cerebral palsy.

D Raymond Knapp¹, Hector Cortes

¹Nemours Children's Clinic, Orlando, Florida 32806, USA. rknapp@nemours.org

Journal of Pediatric Orthopedics

|August 29, 2002

Summary

Hip dislocation in adults with cerebral palsy often presents without pain. Surgical intervention for painful dislocations, like proximal femoral resection, can restore mobility and alleviate discomfort.

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Area of Science:

Orthopedics
Neurology
Rehabilitation Medicine

Background:

Cerebral palsy (CP) frequently leads to hip dislocations in adults.
Understanding the natural history and complications of hip dislocation in CP is crucial for patient management.

Purpose of the Study:

To evaluate the clinical problems and outcomes associated with hip dislocation in adults diagnosed with cerebral palsy.
To assess the efficacy of surgical intervention for painful hip dislocations in this population.

Main Methods:

Retrospective review of 29 adult patients with cerebral palsy and 38 dislocated hips without prior surgery.
Analysis of hip pain, range of motion, and functional outcomes following proximal femoral resection in seven painful hips.

Main Results:

The majority of hip dislocations (71%) in adults with CP were asymptomatic.
A significant minority experienced pain (18% definitely painful, 11% intermittently painful).
Proximal femoral resection in seven painful hips resulted in excellent range of motion and complete pain relief.

Conclusions:

Non-painful hip dislocations in severely affected spastic quadriplegic adults with CP warrant conservative management consideration due to the natural history.
Proximal femoral resection is a reliable and successful treatment for painful hip dislocations or those causing adduction contractures impacting hygiene in adults with CP.

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