Development of hip displacement in cerebral palsy: a longitudinal register study of 1,045 children.
Background and purpose -- Hip surveillance in children with cerebral palsy (CP) includes repeated radiographic hip examinations and measurements of the hip migration percentage (MP) to identify hips in need of surgery early, to prevent dislocation with the fewest number of radiographic examinations...
| Publicado en: | Acta Orthopaedica Vol. 93; pp. 124 - 132 |
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| Autores principales: | , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=162614174&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 162614174 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: 2022 vid: 93 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 162614174 162614174 162614174 10.2340/17453674.2021.851 162614174 ppf: 124 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Development of hip displacement in cerebral palsy: a longitudinal register study of 1,045 children. aug: au: WAGNER, Philippe HÄGGLUND, Gunnar affil: Department of Clinical Sciences, Lund University, Lund, Orthopedics sug: subj: Cerebral Palsy Hip Dislocation Epidemiology Hip Dislocation Prevention and Control Health Screening Hip Dislocation Radiography Hip Surgery Preventive Health Care Human Male Female Prospective Studies Child Sweden Multimethod Studies Descriptive Statistics Comparative Studies Clinical Assessment Tools Child: 6-12 years Male Female ab: Background and purpose -- Hip surveillance in children with cerebral palsy (CP) includes repeated radiographic hip examinations and measurements of the hip migration percentage (MP) to identify hips in need of surgery early, to prevent dislocation with the fewest number of radiographic examinations possible. We analyzed the early development of the MP in hips operated on to prevent hip dislocation and hips stabilized without surgery Patients and methods -- From the Swedish Surveillance Programme for CP, 5,899 radiographic measurements from 1,045 children with a Gross Motor Function Classification System level III--V born in 1996--2011 were analyzed. For children operated on to prevent hip dislocation, measurements up to the most recent preoperative radiograph were included. The hip with highest MP was analyzed for each child. A mixed-effects model was used to estimate the development of the MP at each age for each child and the population mean. Results -- In the 702 children who did not undergo preventive surgery, the mean MP increased with decreasing velocity up to age 6 years. Here it reached 24% (95% confi- dence interval [CI] 24--25), with a velocity of 0.3%/year (CI 0.0--0.5), remaining approximately stable up to age 12 years. In the 343 children who underwent preventive surgery (219 adductor--psoas lengthening, 124 varus derotation osteotomy of proximal femur), the mean MP increased with an increasing velocity from a mean of 30% (CI 27--32) 3 years before the operation. Interpretation -- An increasing rate of hip displacement in hips with an MP > 24% indicates the need for preventive surgery. Hips stabilized without preventive surgery had a decreasing displacement rate and were usually stabilized with an MP < 30% at age 6 years. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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