Cargando…
Risk factors for hip displacement in cerebral palsy: A population-based study of 121 nonambulatory children
PURPOSE: The aim was to evaluate which clinical and radiographic variables are independent (true) risk factors for hip subluxation in nonambulatory children below 5 years of age with cerebral palsy. METHODS: Patients were recruited from a population-based hip surveillance program. Inclusion criteria...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9382709/ https://www.ncbi.nlm.nih.gov/pubmed/35992522 http://dx.doi.org/10.1177/18632521221113424 |
_version_ | 1784769341828366336 |
---|---|
author | Terjesen, Terje Horn, Joachim |
author_facet | Terjesen, Terje Horn, Joachim |
author_sort | Terjesen, Terje |
collection | PubMed |
description | PURPOSE: The aim was to evaluate which clinical and radiographic variables are independent (true) risk factors for hip subluxation in nonambulatory children below 5 years of age with cerebral palsy. METHODS: Patients were recruited from a population-based hip surveillance program. Inclusion criteria were birth during 2002–2006, age below 5 years, and gross motor function classification system levels III–V. In all, 121 children (71 boys) met these criteria. Gross motor function classification system was level III in 29 patients, level IV in 28, and level V in 64. Anteroposterior radiographs at diagnosis and during follow-up were assessed, and only the worst hip of each patient was used for the analyses. The mean age at the initial radiograph was 2.5 years (range: 0.7–4.9 years), and the mean follow-up time was 4.0 years (range: 0.5–11.8 years). RESULTS: At the last follow-up, 67 children had a clinically significant hip displacement, defined as migration percentage ≥40%. Univariable regression analysis defined these risk factors: gross motor function classification system level V, spastic bilateral cerebral palsy, initial migration percentage, yearly rate of migration percentage progression, and initial acetabular index. When these variables were analyzed with multivariable regression in 107 patients with initial migration percentage <50% and follow-up ≥1.0 year, the independent risk factors were initial migration percentage (p = 0.003) and yearly rate of migration percentage progression (p < 0.001). CONCLUSION: The parameters that need to be assessed in hip surveillance in children below 5 years of age are initial migration percentage and rate of migration percentage progression. Acetabular index and femoral head–shaft angle might be useful later for decision-making regarding choice of treatment. LEVEL OF EVIDENCE: Level II, development of diagnostic criteria. |
format | Online Article Text |
id | pubmed-9382709 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-93827092022-08-18 Risk factors for hip displacement in cerebral palsy: A population-based study of 121 nonambulatory children Terjesen, Terje Horn, Joachim J Child Orthop Neuromuscular disorders PURPOSE: The aim was to evaluate which clinical and radiographic variables are independent (true) risk factors for hip subluxation in nonambulatory children below 5 years of age with cerebral palsy. METHODS: Patients were recruited from a population-based hip surveillance program. Inclusion criteria were birth during 2002–2006, age below 5 years, and gross motor function classification system levels III–V. In all, 121 children (71 boys) met these criteria. Gross motor function classification system was level III in 29 patients, level IV in 28, and level V in 64. Anteroposterior radiographs at diagnosis and during follow-up were assessed, and only the worst hip of each patient was used for the analyses. The mean age at the initial radiograph was 2.5 years (range: 0.7–4.9 years), and the mean follow-up time was 4.0 years (range: 0.5–11.8 years). RESULTS: At the last follow-up, 67 children had a clinically significant hip displacement, defined as migration percentage ≥40%. Univariable regression analysis defined these risk factors: gross motor function classification system level V, spastic bilateral cerebral palsy, initial migration percentage, yearly rate of migration percentage progression, and initial acetabular index. When these variables were analyzed with multivariable regression in 107 patients with initial migration percentage <50% and follow-up ≥1.0 year, the independent risk factors were initial migration percentage (p = 0.003) and yearly rate of migration percentage progression (p < 0.001). CONCLUSION: The parameters that need to be assessed in hip surveillance in children below 5 years of age are initial migration percentage and rate of migration percentage progression. Acetabular index and femoral head–shaft angle might be useful later for decision-making regarding choice of treatment. LEVEL OF EVIDENCE: Level II, development of diagnostic criteria. SAGE Publications 2022-08-02 2022-08 /pmc/articles/PMC9382709/ /pubmed/35992522 http://dx.doi.org/10.1177/18632521221113424 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Neuromuscular disorders Terjesen, Terje Horn, Joachim Risk factors for hip displacement in cerebral palsy: A population-based study of 121 nonambulatory children |
title | Risk factors for hip displacement in cerebral palsy: A
population-based study of 121 nonambulatory children |
title_full | Risk factors for hip displacement in cerebral palsy: A
population-based study of 121 nonambulatory children |
title_fullStr | Risk factors for hip displacement in cerebral palsy: A
population-based study of 121 nonambulatory children |
title_full_unstemmed | Risk factors for hip displacement in cerebral palsy: A
population-based study of 121 nonambulatory children |
title_short | Risk factors for hip displacement in cerebral palsy: A
population-based study of 121 nonambulatory children |
title_sort | risk factors for hip displacement in cerebral palsy: a
population-based study of 121 nonambulatory children |
topic | Neuromuscular disorders |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9382709/ https://www.ncbi.nlm.nih.gov/pubmed/35992522 http://dx.doi.org/10.1177/18632521221113424 |
work_keys_str_mv | AT terjesenterje riskfactorsforhipdisplacementincerebralpalsyapopulationbasedstudyof121nonambulatorychildren AT hornjoachim riskfactorsforhipdisplacementincerebralpalsyapopulationbasedstudyof121nonambulatorychildren |