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Head-shaft angle is a risk factor for hip displacement in children with cerebral palsy.

Hermanson, Maria LU ; Hägglund, Gunnar LU ; Riad, Jacques and Wagner, Philippe LU (2015) In Acta Orthopaedica 86(2). p.229-232
Abstract
Background and purpose - Hip dislocation in children with cerebral palsy (CP) is a common and severe problem. The Swedish follow-up program for CP (CPUP) includes standardized monitoring of the hips. Migration percentage (MP) is a widely accepted measure of hip displacement. Coxa valga and valgus of the femoral head in relation to the femoral neck can be measured as the head-shaft angle (HSA). We assessed HSA as a risk factor for hip displacement in CP. Patients and methods - We analyzed radiographs of children within CPUP from selected regions of Sweden. Inclusion criteria were children with Gross Motor Function Classification System (GMFCS) levels III-V, MP of < 40% in both hips at the first radiograph, and a follow-up period of 5... (More)
Background and purpose - Hip dislocation in children with cerebral palsy (CP) is a common and severe problem. The Swedish follow-up program for CP (CPUP) includes standardized monitoring of the hips. Migration percentage (MP) is a widely accepted measure of hip displacement. Coxa valga and valgus of the femoral head in relation to the femoral neck can be measured as the head-shaft angle (HSA). We assessed HSA as a risk factor for hip displacement in CP. Patients and methods - We analyzed radiographs of children within CPUP from selected regions of Sweden. Inclusion criteria were children with Gross Motor Function Classification System (GMFCS) levels III-V, MP of < 40% in both hips at the first radiograph, and a follow-up period of 5 years or until development of MP > 40% of either hip within 5 years. Risk ratio between children who differed in HSA by 1 degree was calculated and corrected for age, MP, and GMFCS level using multiple Poisson regression. Results - 145 children (73 boys) with a mean age of 3.5 (0.6-9.7) years at the initial radiograph were included. 51 children developed hip displacement whereas 94 children maintained a MP of < 40%. The risk ratio for hip displacement was 1.05 (p < 0.001; 95% CI 1.02-1.08). When comparing 2 children of the same age, GMFCS level, and MP, a 10-degree difference in HSA results in a 1.6-times higher risk of hip displacement in the child with the higher HSA. Interpretation - A high HSA appears to be a risk factor for hip displacement in children with CP. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
86
issue
2
pages
229 - 232
publisher
Taylor & Francis
external identifiers
  • pmid:25428756
  • wos:000351740100014
  • scopus:84925965545
ISSN
1745-3682
DOI
10.3109/17453674.2014.991628
language
English
LU publication?
yes
id
1fdac75b-5b19-47da-9df5-e7b385c1c0ab (old id 4815881)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25428756?dopt=Abstract
date added to LUP
2014-12-06 19:05:48
date last changed
2017-08-13 03:15:02
@article{1fdac75b-5b19-47da-9df5-e7b385c1c0ab,
  abstract     = {Background and purpose - Hip dislocation in children with cerebral palsy (CP) is a common and severe problem. The Swedish follow-up program for CP (CPUP) includes standardized monitoring of the hips. Migration percentage (MP) is a widely accepted measure of hip displacement. Coxa valga and valgus of the femoral head in relation to the femoral neck can be measured as the head-shaft angle (HSA). We assessed HSA as a risk factor for hip displacement in CP. Patients and methods - We analyzed radiographs of children within CPUP from selected regions of Sweden. Inclusion criteria were children with Gross Motor Function Classification System (GMFCS) levels III-V, MP of &lt; 40% in both hips at the first radiograph, and a follow-up period of 5 years or until development of MP &gt; 40% of either hip within 5 years. Risk ratio between children who differed in HSA by 1 degree was calculated and corrected for age, MP, and GMFCS level using multiple Poisson regression. Results - 145 children (73 boys) with a mean age of 3.5 (0.6-9.7) years at the initial radiograph were included. 51 children developed hip displacement whereas 94 children maintained a MP of &lt; 40%. The risk ratio for hip displacement was 1.05 (p &lt; 0.001; 95% CI 1.02-1.08). When comparing 2 children of the same age, GMFCS level, and MP, a 10-degree difference in HSA results in a 1.6-times higher risk of hip displacement in the child with the higher HSA. Interpretation - A high HSA appears to be a risk factor for hip displacement in children with CP.},
  author       = {Hermanson, Maria and Hägglund, Gunnar and Riad, Jacques and Wagner, Philippe},
  issn         = {1745-3682},
  language     = {eng},
  number       = {2},
  pages        = {229--232},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Head-shaft angle is a risk factor for hip displacement in children with cerebral palsy.},
  url          = {http://dx.doi.org/10.3109/17453674.2014.991628},
  volume       = {86},
  year         = {2015},
}