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The head shaft angle is associated with hip displacement in children at GMFCS levels III-V - A population based study

Finlayson, L. ; Czuba, T. LU ; Gaston, M. S. ; Hägglund, G. LU and Robb, J. E. (2018) In BMC Musculoskeletal Disorders 19(1).
Abstract

Background: An increased Head Shaft Angle (HSA) has been reported as a risk factor for hip displacement in children with cerebral palsy (CP) but opinions differ in the literature. The purpose of this study was to re-evaluate the relationship between HSA and hip displacement in a different population of children with CP. Methods: The Cerebral Palsy Integrated Pathway Scotland surveillance programme includes 95% of all children with CP in Scotland. The pelvic radiographs from 640 children in GMFCS levels III-V were chosen. The most displaced hip was analysed and the radiographs used were those taken at the child's first registration in the database to avoid the potential effects of surveillance on subsequent hip centration. A logistic... (More)

Background: An increased Head Shaft Angle (HSA) has been reported as a risk factor for hip displacement in children with cerebral palsy (CP) but opinions differ in the literature. The purpose of this study was to re-evaluate the relationship between HSA and hip displacement in a different population of children with CP. Methods: The Cerebral Palsy Integrated Pathway Scotland surveillance programme includes 95% of all children with CP in Scotland. The pelvic radiographs from 640 children in GMFCS levels III-V were chosen. The most displaced hip was analysed and the radiographs used were those taken at the child's first registration in the database to avoid the potential effects of surveillance on subsequent hip centration. A logistic regression model was used with hip displacement (migration percentage [MP] ≥40%) as outcome and HSA, GMFCS, age and sex as covariates. Results: The MP was ≥40% in 118 hips with a mean HSA of 164° (range 121-180°) and < 40% in 522 hips with a mean HSA of 160° (range 111-180°). The logistic regression analysis showed no significant influence of age and sex on MP in this population but a high GMFCS level was strongly associated with hip displacement. An increased HSA was also associated with hip displacement, a 10° difference in HSA for children adjusted for age, sex, and GMFCS gave an odds ratio of 1.26 for hip displacement equal or above 40% (p = 0.009) and hips with HSA above 164.5 degrees had an odds ratio of 1.96 compared with hips with HSA below 164.5 degrees (p = 0.002). Conclusion: These findings confirm that HSA is associated with hip displacement in children in GMFCS levels III-V.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebral palsy, Children, Head shaft angle, Hip displacement
in
BMC Musculoskeletal Disorders
volume
19
issue
1
article number
356
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85054445827
  • pmid:30286753
ISSN
1471-2474
DOI
10.1186/s12891-018-2275-4
language
English
LU publication?
yes
id
a1d4bb40-e8d6-4464-a506-98a728c2511c
date added to LUP
2018-10-30 14:39:30
date last changed
2024-04-01 14:14:44
@article{a1d4bb40-e8d6-4464-a506-98a728c2511c,
  abstract     = {{<p>Background: An increased Head Shaft Angle (HSA) has been reported as a risk factor for hip displacement in children with cerebral palsy (CP) but opinions differ in the literature. The purpose of this study was to re-evaluate the relationship between HSA and hip displacement in a different population of children with CP. Methods: The Cerebral Palsy Integrated Pathway Scotland surveillance programme includes 95% of all children with CP in Scotland. The pelvic radiographs from 640 children in GMFCS levels III-V were chosen. The most displaced hip was analysed and the radiographs used were those taken at the child's first registration in the database to avoid the potential effects of surveillance on subsequent hip centration. A logistic regression model was used with hip displacement (migration percentage [MP] ≥40%) as outcome and HSA, GMFCS, age and sex as covariates. Results: The MP was ≥40% in 118 hips with a mean HSA of 164° (range 121-180°) and &lt; 40% in 522 hips with a mean HSA of 160° (range 111-180°). The logistic regression analysis showed no significant influence of age and sex on MP in this population but a high GMFCS level was strongly associated with hip displacement. An increased HSA was also associated with hip displacement, a 10° difference in HSA for children adjusted for age, sex, and GMFCS gave an odds ratio of 1.26 for hip displacement equal or above 40% (p = 0.009) and hips with HSA above 164.5 degrees had an odds ratio of 1.96 compared with hips with HSA below 164.5 degrees (p = 0.002). Conclusion: These findings confirm that HSA is associated with hip displacement in children in GMFCS levels III-V.</p>}},
  author       = {{Finlayson, L. and Czuba, T. and Gaston, M. S. and Hägglund, G. and Robb, J. E.}},
  issn         = {{1471-2474}},
  keywords     = {{Cerebral palsy; Children; Head shaft angle; Hip displacement}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Musculoskeletal Disorders}},
  title        = {{The head shaft angle is associated with hip displacement in children at GMFCS levels III-V - A population based study}},
  url          = {{http://dx.doi.org/10.1186/s12891-018-2275-4}},
  doi          = {{10.1186/s12891-018-2275-4}},
  volume       = {{19}},
  year         = {{2018}},
}