medigraphic.com
ISSN 1405-8790 (Print)

2015, Number 3-4

<< Back Next >>

Rev Mex Med Fis Rehab 2015; 27 (3-4)

Implementation of preventive treatments for hip disorders in cerebral palsy: a preliminary study in Granada

Alí-Morell OJ, Zurita-Ortega F, Fernández-Estévez B, Cubillo-Cobo R, Navarro-Díaz JC

Language: English
References: 30
Page: 71-79
PDF size: 216.61 Kb.


ABSTRACT

Background: Hip subluxation and dislocation are one of the most frequent musculoskeletal disorders observed in patients with cerebral palsy (CP).This study pretends to demonstrate the implementation percentage of preventive treatments for hip displacement in the population of Granada affected by cerebral palsy, as well as their results. Methods: 35 subjects with CP (age range 8-20 years) participated in a retrospective observational study. Preventive treatments for hip disorders were analyzed, as well as the degree of coxofemoral joint decoaptation. Data concerning preventive treatments using botulinum toxin injections (BTA), orthoses and soft tissue release surgery (STRS), was gathered. Coxofemoral morphology was measured through X-rays using Reimer’s Migration Index (RMI). Results: Total percentage of hip dislocation/subluxation was 31.4%. For subjects belonging to levels IV and V according to Gross Motor Function Classification System (GMFCS), the implementation percentage of the studied preventive treatments was less than 50%. Furthermore, for all these levels, the percentage of subjects that received BTA and STRS and didn’t present RMI › 30%, was above 60%. Conclusions: In our population belonging to levels IV and V of GMFCS, the implementation percentages of BTA and STRS were low. The limited application of these preventive treatments results in a great number of hip disorders.


REFERENCES

  1. Dobson F, Boyd RN, Parrott J, Nattrass GR, Graham HK. Hip surveillance in children with cerebral palsy. Impact on the surgical management of spastic hip disease. J Bone Joint Surg Br. 2002; 84 (5): 720-726.

  2. Soo B, Howard JJ, Boyd RN, Reid SM, Lanigan A, Wolfe R et al. Hip displacement in cerebral palsy. J Bone Joint Surg Am. 2006; 88 (1): 121-129.

  3. Boyd RN, Jordan R, Pareezer L, Moodie A, Finn C, Luther B et al. Australian Cerebral Palsy Child Study: protocol of a prospective population based study of motor and brain development of preschool aged children with cerebral palsy. BMC Neurol. 2013; 13: 57.

  4. Penner M, Xie WY, Binepal N, Switzer L, Fehlings D. Characteristics of pain in children and youth with cerebral palsy. Pediatrics. 2013; 132 (2): e407-413.

  5. Krebs A, Strobl WM, Grill F. Neurogenic hip dislocation in cerebral palsy: quality of life and results alter hip reconstruction. J Child Orthop. 2008; 2 (2): 125-131.

  6. Mallet C, Ilharreborde B, Presedo A, Khairouni A, Mazda K, Pennecot GF. One-stage hip reconstruction in children with cerebral palsy: long term results at skeletal madurity. J Child Orthop. 2014; 8 (3): 221-228.

  7. Pountney T, Green EM. Hip dislocation in cerebral palsy. BMJ. 2006; 332 (7544): 772-775.

  8. Shore B, Spence D, Graham H. The role for hip surveillance in children with cerebral palsy. Curr Rev Musculoskelet Med. 2012; 5 (2): 126-134.

  9. Kapandji AI. The physiology of the joints: the lower limb. 4ª Ed. Barcelona: Masson, 1990.

  10. Ardila OJ, Divo EA, Moslehy FA, Rab GT, Kassab AJ, Price CT. Mechanics of hip dysplasia reductions in infants using the Pavlik harness: a physics-based computational model. J Biomech. 2013; 46 (9): 1501-1507.

  11. Copeland L, Edwards P, Thorley M, Donaghey S, Gascoigne-Pees L, Kentish M et al. Botulinum toxin A for nonambulatory children with cerebral palsy: a double blind randomized controlled trial. J Pediatr. 2014; 165 (1): 140-146.

  12. Jung NH, Heinen F, Westhoff B, Doederlein L, Reissiq A, Berweck S et al. Hip lateralisation in children with bilateral spastic cerebral palsy treated with botulinum toxin type A: a 2-year follow up. Neuropediatrics. 2011; 42 (1): 18-23.

  13. Picciolini O, Albisetti W, Cozzaqlio M, Spreafico F, Mosca F, Gasparroni V. “Postural Management” to prevent hip dislocation in children with cerebral palsy. Hip Int. 2009; 19 (Suppl 6): S56-62.

  14. Portinaro N, Panou A, Gagliano N, Pelillo F. D.D.S.H.: developmental dysplasia of the spastic hip: strategies of management in cerebral palsy. A new suggestive algorithm. Hip Int. 2009; 19 (Suppl 6): S69-74.

  15. Valencia FG. Management of hip deformities in cerebral palsy. Orthop Clin North Am. 2010; 41 (4): 549-559.

  16. Larnet P, Risto O, Hägglund G, Wagner P. Hip displacement in relation to age and gross motor function in children with cerebral palsy. J Child Orthop. 2014; 8 (2): 129-134.

  17. Presedo A, Oh CW, Dabney KW, Miller F. Soft-tissue releases to treat spastic hip subluxation in children with cerebral palsy. J Bone Joint Surg Am. 2005; 87: 832-841.

  18. Shore BJ et al. Adductor surgery to prevent hip displacement in children with cerebral palsy: the predictive role of the Gross Motor Function Classification System. J Bone Joint Surgery. 2012; 94 (4): 326-334.

  19. Bouwhuis CB, van der Heijden-Maessen HC, Boldingh EJ, Bos CF, Lankhorst GJ. Effectiveness of preventive and corrective surgical intervention on hip disorders in severe cerebral palsy: a systematic review. Disabil Rehabil. 2015; 37: 97-105.

  20. Reimers J. The stability of the hip in children. A radiological study of the results of muscle surgery in cerebral palsy. Acta Orthop Scand Suppl. 1980; 184: 1-100.

  21. Hägglund G, Lauge-Pedersen H, Persson M. Radiographic threshold values for hip screening in cerebral palsy. J Child Orthop. 2007; 1 (1): 43-47.

  22. Robin J, Graham HK, Baker R, Selber P, Simpson P, Symons S et al. A classification system for hip disease in cerebral palsy. Dev Med Child Neurol. 2009; 51 (3): 183-192.

  23. De Andrés-Nogales F, Morell A, Aracil J, Torres C, Oyagüez I, Casado MA. Cost analysis of the use of botulinum toxin type A in Spain. Farm Hosp. 2014; 38 (3): 193-201.

  24. Elkamil AI, Andersen GL, Hägglund G, Lamvik T, Skranes J, Vik T. Prevalence of hip dislocation among children with cerebral palsy in regions with and without a surveillance programme: a cross sectional study in Sweden and Norway. BMC Musculoskelet Disord. 2011; 12: 284.

  25. Hägglund G, Andersson S, Düppe H, Lauge-Pedersen H, Nordmark E, Westbom L. Prevention of dislocation ot the hip in children with cerebral palsy. The first ten years of a population-based prevention programme. J Bone Joint Surg Br. 2005; 87: 95-101.

  26. Colovic H, Dimitrijevic L, Stankovic I, Nikolic D, Radovic-Janosevic D. Estimation of botulinum toxin type A efficacy on spasticity and functional outcome in children with spastic cerebral palsy. Biomed pap Med Fac Unive palacky Olomouc Czech Repub. 2012; 156: 41-47.

  27. Molenaers G, Fagard K, Van Campenhout A, Desloovere K. Botulinum toxin A treatment of lower extremities in children with cerebral palsy. J Child Orthop. 2013; 7: 383-387.

  28. Pin TW, Elmasry J, Lewis J. Efficacy of botulinum toxin A in children with cerebral palsy in Gross Motor Function Classification System levels IV and V: a systematic review. Dev Med Child Neurol. 2013; 55: 304-313.

  29. Kim MO, Lee JH, Yu JY, An PS, Hur do H, Park ES et al. Changes of musculoskeletal deformity in severely disabled children using the custom molded fitting chair. Ann Rehabil Med. 2013; 37: 33-40.

  30. Bishay SN. Short-term results of musculotendinous release for paralytic hip subluxation in children with spastic cerebral palsy. Ann R Coll Surg Engl. 2008; 90: 127-132.




2020     |     www.medigraphic.com