Surgical management of hip problem of spastic cerebral palsy in children

Abstract

Cerebral palsy (CP) is the most common disability in childhood. As a non-progressive neurological disturbance in developing fetal or infant brain, it affects posture and movement and involves a changing clinical presentation across the years spanning childhood. Spastic cerebral palsy is due to damaged cone system. And hip dysplasia is under intense researches. Hip joint in children with CP is thought to be essentially normal at birth and progressive displacement towards dislocation impacts care, comfort and function. With advancing age, there is a higher incidence of subluxation or dislocation. And 25%-75% of these hips becoming painful so as to decrease the ambulatory patient's capability of walking or standing. Despite effective preventions, orthopedic surgeons always perform surgery for hip subluxation or dislocation in severely affected CP patients. The goal of these procedures is to retain located, mobile and painless hips. This paper offers a latest summary of research progress of preoperative assessments, surgical procedures and prognosis of hip dysplasia in children with spastic CP. Key words: Cerebral palsy; Hip joint; Surgical procedure, operative; Child