Hips abnormalities in children with cerebral palsy

Abstract

Cerebral palsy is considered a neurological disorder caused by a non-progressive brain injury. Hips abnormalities in child with cerebral palsy are the consequence of the neurological disorder in growth period. To identify Hip abnormalities in children with cerebral palsy and to determine orthopedic and preventives treatment modalities through a review of the literature and our experience in the rehabilitation unit in Mahdia. We have conducted a prospective study during the last three years on children with cerebral palsy referred to our unit. The assessment was based on clinical examination (a full neurological examination, a complete articular balance), gait analysis, functional assessment and radiographic analysis (spine X-Ray: front and side view, anteroposterior pelvic radiograph: without and with hips in maximum abduction). A rehabilitation protocol was implemented and adjusted according to clinical assessment. Thirty children with cerebral palsy enrolled with an average age of 4 years and 6 months. 60% were quadriplegic, 35% were paraplegics. Orthopedic abnormalities of the hip found were flexion deformity in 80% of cases, defect in hip abduction in 66% of cases, subluxation in 43% of cases, dislocation in 2 cases and dysplasia in 62% of cases. Spinal deformities associated in 60% of cases. All our children had benefited from rehabilitation and suitable orthesis. Dislocations were referred to the surgeon [1] . Vicious attitudes are the result of muscular imbalance caused by the neurological disorder. The postural collapse and poor positioning aggravate deformities. Abnormalities most frequently encountered are the flexion deformity, defect in hip abduction, defect in external rotation, subluxation and dislocation. Rehabilitation helps to reduce muscle imbalance, bad posture and postural collapse in children with cerebral palsy. Hips deformities are important concerns for the clinician. Rehabilitation holds a special place in prevention and management.