Management of Moderate to Severe Hip Displacement in Nonambulatory Children with Cerebral Palsy скачать в хорошем качестве

Management of Moderate to Severe Hip Displacement in Nonambulatory Children with Cerebral Palsy

Full video article: https://jbjs.org/reader.php?source=JB... Spastic hip displacement is the second most common musculoskeletal deformity in children with cerebral palsy, after equinus of the ankle. Population-based studies have shown that hip displacement affects approximately one-third of children with cerebral palsy and is directly related to limitations in gross motor function, as measured by the Gross Motor Function Classification System (GMFCS). Children with cerebral palsy have both increased femoral-neck anteversion and neck-shaft angle, with nonambulatory children having the greatest increases from normal. Isolated soft-tissue surgical procedures for the treatment of progressive hip displacement in nonambulatory children with cerebral palsy are unlikely to be successful as a definitive treatment. However, appropriate lengthening of the hip adductors and flexors can delay the timing of osseous reconstruction to a more appropriate age and stage in the child’s development, which may be advantageous. An osseous reconstructive surgical procedure in nonambulatory children with cerebral palsy is often necessary; consider age, bilaterality, and combined femoral and pelvic procedures when planning operative intervention. A morphologically well-developed hip is usually pain-free; facilitates comfortable sitting and transfers and ease of care for those who require assistance with personal hygiene; and contributes to higher levels of health-related quality of life.