Hip surveillance and management of the displaced hip in cerebral palsy
1School of Medicine, University of St Andrews, St Andrews, KY16 9TF Scotland, UK.
Insights
Early surveillance and preventive treatment can prevent hip dislocation in children with cerebral palsy (CP). A structured program using age, GMFCS level, and migration percentage (MP) guides timely intervention for better outcomes.
Area of Science:
- Pediatric Orthopedics
- Cerebral Palsy Management
- Hip Dysplasia
Background:
- Displaced hip is a common complication in children with cerebral palsy (CP).
- Management involves surveillance, surgical reconstruction, and salvage options for unreconstructable hips.
Purpose of the Study:
- To provide an overview of managing displaced hips in children with CP.
- To discuss surveillance programs, surgical principles, and salvage techniques.
Main Methods:
- Review of current literature and clinical practices.
- Emphasis on surveillance programs incorporating radiographic and clinical assessments.
- Consideration of preventive treatment based on migration percentage (MP).
Main Results:
- Hip dislocation in CP is potentially preventable with early detection and intervention.
- Surveillance programs should be tailored to the child's age, GMFCS level, and MP.
- Preventive surgery is indicated for MP exceeding 33%.
Conclusions:
- Implementing early surveillance programs can significantly reduce hip dislocation in children with CP.
- Personalized surveillance strategies are crucial for effective management.
- Timely surgical intervention based on MP can prevent further displacement and improve hip health.
Introduction:
This article provides an overview of the management of a displaced hip in children with cerebral palsy and considers surveillance programmes, principles of surgical reconstruction and options for the salvage of an unreconstructable hip in these children.
Conclusion:
Hip dislocation in CP is potentially preventable if children are included from an early age in a surveillance programme that includes repeat radiographic and clinical examinations, and preventive treatment for hips that are displacing. A surveillance programme should be based on the child's age, GMFCS level and migration percentage (MP), and surgical prevention may be considered in children with a MP exceeding 33 %.
