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Head-shaft angle is a risk factor for hip displacement in children with cerebral palsy
d epartment of Clinical s cience, o rthopedic s urgery, s kåne u niversity Hospital, Lund.
2015 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 86, no 2, 229-232 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2015. Vol. 86, no 2, 229-232 p.
National Category
Orthopedics
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URN: urn:nbn:se:uu:diva-281765DOI: 10.3109/17453674.2014.991628PubMedID: 25428756OAI: oai:DiVA.org:uu-281765DiVA: diva2:915525
Available from: 2016-03-30 Created: 2016-03-30 Last updated: 2017-05-04Bibliographically approved

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Wagner, Philippe

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