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Head-shaft angle is a risk factor for hip displacement in children with cerebral palsy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
2015 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 86, no 2Article 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
National Category
Medical and Health Sciences
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: 2016-03-30

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