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Windswept hip deformity in children with cerebral palsy: a population-based prospective follow-up.

Hägglund G, Lauge-Pedersen H, Persson Bunke M, Rodby-Bousquet E - J Child Orthop (2016)

Bottom Line: All children born between 1990 and 1995 with CP were included; those born between 1990 and 1991 did not partake in the hip surveillance program until they were older (3-5 years of age) and served as a historic control group.The number of children with WS starting in the lower extremities was significantly lower in the study group (p = 0.028).With early inclusion in a hip surveillance program and early treatment of contractures, it appears possible to reduce the frequency of WS starting in the lower extremities.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Sciences, Lund, Orthopaedics, Lund University, 22185, Lund, Sweden. gunnar.hagglund@med.lu.se.

ABSTRACT

Purpose: To analyze the development of windswept hip deformity (WS) in a total population of children with cerebral palsy (CP) up to 20 years of age, the association between WS and hip dislocation, and femoral varus osteotomy and scoliosis, and the impact of a hip surveillance program on the subsequent incidence of WS.

Methods: This is a prospective study on children with CP in southern Sweden included in the Swedish follow-up programme and registry for CP (CPUP). All children born between 1990 and 1995 with CP were included; those born between 1990 and 1991 did not partake in the hip surveillance program until they were older (3-5 years of age) and served as a historic control group. Children born between 1992 and 1995 were included in the hip surveillance program from about 2 years of age and constituted the study group.

Results: In the control group, 12 of 68 children (18 %) developed WS. In the study group of 139 children, 13 (9 %) developed WS (p = 0.071). Of all 25 children with WS, 21 also developed scoliosis and 5 developed a hip dislocation. The number of children with WS starting in the lower extremities was significantly lower in the study group (p = 0.028). No difference between the two groups was seen regarding WS that started in combination with scoliosis.

Conclusion: With early inclusion in a hip surveillance program and early treatment of contractures, it appears possible to reduce the frequency of WS starting in the lower extremities.

No MeSH data available.


Related in: MedlinePlus

Percentages of children with windswept hip deformity (WS) in the total population of children with cerebral palsy (CP) born in 1990–1991 (control group, n = 71) and in 1992–1995 (study group, n = 143), according to the levels of Gross Motor Function Classification System (GMFCS)
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Fig1: Percentages of children with windswept hip deformity (WS) in the total population of children with cerebral palsy (CP) born in 1990–1991 (control group, n = 71) and in 1992–1995 (study group, n = 143), according to the levels of Gross Motor Function Classification System (GMFCS)

Mentions: The frequency of WS increased from 12 % in the control group at 10 years of age to 18 % at 20 years of age and from 7 to 9 % in the study group. The frequency of WS was associated with gross motor function, with 52 % of those at GMFCS level V being affected (Fig. 1). The proportion of children with WS starting in the lower extremity was lower in the study group, whereas the numbers of children with WS starting from the spine were the same in both groups. The only known difference between the groups was that those in the study group were included in the surveillance program early, often before the age of 2 years, which highlights the importance of initiating the standardized follow-up of children with CP very early.Fig. 1


Windswept hip deformity in children with cerebral palsy: a population-based prospective follow-up.

Hägglund G, Lauge-Pedersen H, Persson Bunke M, Rodby-Bousquet E - J Child Orthop (2016)

Percentages of children with windswept hip deformity (WS) in the total population of children with cerebral palsy (CP) born in 1990–1991 (control group, n = 71) and in 1992–1995 (study group, n = 143), according to the levels of Gross Motor Function Classification System (GMFCS)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940244&req=5

Fig1: Percentages of children with windswept hip deformity (WS) in the total population of children with cerebral palsy (CP) born in 1990–1991 (control group, n = 71) and in 1992–1995 (study group, n = 143), according to the levels of Gross Motor Function Classification System (GMFCS)
Mentions: The frequency of WS increased from 12 % in the control group at 10 years of age to 18 % at 20 years of age and from 7 to 9 % in the study group. The frequency of WS was associated with gross motor function, with 52 % of those at GMFCS level V being affected (Fig. 1). The proportion of children with WS starting in the lower extremity was lower in the study group, whereas the numbers of children with WS starting from the spine were the same in both groups. The only known difference between the groups was that those in the study group were included in the surveillance program early, often before the age of 2 years, which highlights the importance of initiating the standardized follow-up of children with CP very early.Fig. 1

Bottom Line: All children born between 1990 and 1995 with CP were included; those born between 1990 and 1991 did not partake in the hip surveillance program until they were older (3-5 years of age) and served as a historic control group.The number of children with WS starting in the lower extremities was significantly lower in the study group (p = 0.028).With early inclusion in a hip surveillance program and early treatment of contractures, it appears possible to reduce the frequency of WS starting in the lower extremities.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Sciences, Lund, Orthopaedics, Lund University, 22185, Lund, Sweden. gunnar.hagglund@med.lu.se.

ABSTRACT

Purpose: To analyze the development of windswept hip deformity (WS) in a total population of children with cerebral palsy (CP) up to 20 years of age, the association between WS and hip dislocation, and femoral varus osteotomy and scoliosis, and the impact of a hip surveillance program on the subsequent incidence of WS.

Methods: This is a prospective study on children with CP in southern Sweden included in the Swedish follow-up programme and registry for CP (CPUP). All children born between 1990 and 1995 with CP were included; those born between 1990 and 1991 did not partake in the hip surveillance program until they were older (3-5 years of age) and served as a historic control group. Children born between 1992 and 1995 were included in the hip surveillance program from about 2 years of age and constituted the study group.

Results: In the control group, 12 of 68 children (18 %) developed WS. In the study group of 139 children, 13 (9 %) developed WS (p = 0.071). Of all 25 children with WS, 21 also developed scoliosis and 5 developed a hip dislocation. The number of children with WS starting in the lower extremities was significantly lower in the study group (p = 0.028). No difference between the two groups was seen regarding WS that started in combination with scoliosis.

Conclusion: With early inclusion in a hip surveillance program and early treatment of contractures, it appears possible to reduce the frequency of WS starting in the lower extremities.

No MeSH data available.


Related in: MedlinePlus