Hip surgery and radiology reporting for children with cerebral palsy prior to initiation of a hip surveillance program

2021 ◽  
pp. 1-7
Author(s):  
Kyra Kane ◽  
Marshall Siemens ◽  
Shane Wunder ◽  
Jacqueline Kraushaar ◽  
J. Alexandra Mortimer ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Retrospective Chart Review ◽  
Surveillance Program ◽  
Radiology Reporting ◽  
Reporting Practices ◽  
Hip Displacement ◽  
Primary Surgery ◽  
Radiology Reports ◽  
Children With Cerebral Palsy ◽  
Surveillance Programs

PURPOSE: Hip displacement impacts quality of life for many children with cerebral palsy (CP). While early detection can help avoid dislocation and late-stage surgery, formalized surveillance programs are not ubiquitous. This study aimed to examine: 1) surgical practices around pediatric hip displacement for children with CP in a region without formalized hip surveillance; and 2) utility of MP compared to traditional radiology reporting for quantifying displacement. METHODS: A retrospective chart review examined hip displacement surgeries performed on children with CP between 2007–2016. Surgeries were classified as preventative, reconstructive, or salvage. Pre- and post-operative migration percentage (MP) was calculated for available radiographs using a mobile application and compared using Wilcoxon Signed Ranks test. MPs were also compared with descriptions in the corresponding radiology reports using directed and conventional content analyses. RESULTS: Data from 67 children (115 surgical hips) was included. Primary surgery types included preventative (63.5% hips), reconstructive (36.5%), or salvage (0%). For the 92 hips with both radiology reports and radiographs available, reports contained a range of descriptors that inconsistently reflected the retrospectively-calculated MPs. CONCLUSION: Current radiology reporting practices do not appear to effectively describe hip displacement for children with CP. Therefore, standardized reporting of MP is recommended.

scholarly journals Evaluation of the effectiveness of screening and monitoring program for early prevention of orthopedic complications in children with cerebral palsy

2020 ◽  
Vol 64 (6) ◽  
pp. 79-83
Author(s):  
V. A. Zmanovskaya ◽  
E. V. Kashuba ◽  
R. I. Valeev ◽  
O. Yu. Ezhov
Keyword(s):  
Cerebral Palsy ◽  
Monitoring Program ◽  
Motor Impairment ◽  
Hip Dislocation ◽  
Preventive Treatment ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Surveillance Program ◽  
Children With Cerebral Palsy ◽  
Hip Luxation

Hip instability and following hip luxation and subluxations remain common and serious problem among children with cerebral palsy (CP). The hip luxation and subluxations can be avoided using timely monitoring and early preventive treatment. However, standard scheme for patients’ management in children with CP is not adopted so far in Russian Federation. In 2014 on the territory of Tyumen region the Europe surveillance program for children with CP (CPUP) was introduced.Research purpose. To analyze the effectiveness of the early orthopedic complications prevention program in children with CP. Material and methods. The study included children with CP of the «Child psychoneurological medical-rehabilitation center «Nadezhda» register born in 2010 and earlier (n=176), undergoing surveillance under the European Program (main group); the comparison group consisted of children with CP which were treated before the adoption of the program (n=642). Group comparability was achieved by selecting children with one level of motor impairment according to the GMFCS classification. The presence of expressed orthopedic complications was exposed at the value of Reimers Index (RI) above 40%, and the effectiveness of the program was determined by a reduction in the frequency of such RI.Results. It was found that overall incidence of hip dislocation in control group decreased by 70%: in children with GMFCS II by 100%, GMFCS III – by 78%, GMFCS IV – by 62% and GMFCS V – by 74%.Conclusion. Due to the introduction of the Europe surveillance program on the territory of Tyumen region there is a significant decrease in orthopedic complications incidence in children with CP.

scholarly journals Hip displacement in children with cerebral palsy in Scotland: a total population study

2018 ◽  
Vol 12 (6) ◽  
pp. 635-639 ◽  
Author(s):  
K. E. Bugler ◽  
M. S. Gaston ◽  
J. E. Robb
Keyword(s):  
Cerebral Palsy ◽  
Total Population ◽  
Hip Dislocation ◽  
Level Of Evidence ◽  
Surveillance Programme ◽  
Hip Displacement ◽  
Number Of Children ◽  
Children With Cerebral Palsy ◽  
Migration Percentage ◽  
Gmfcs Level

Purpose The purpose of this study is to report the number of children from a total population of children with cerebral palsy (CP) in Scotland who had a displaced or dislocated hip at first registration in a national surveillance programme. Methods Migration percentage (MP), laterality, Gross Motor Function Classification System (GMFCS) level, CP subtype, distribution of CP and age were analyzed in 1171 children. Relative risk was calculated with 95% confidence intervals. Hip displacement and dislocation were defined as a MP of 40 to 99 and > 100 respectively. Results Radiographs were available from the first assessment of 1171 children out of 1933 children registered on the system. In all, 2.5% of children had either one or both hips dislocated (29/1171) and dislocation only occurred in children of GMFCS levels IV and V. A total of 10% of children had a MP 40 to 99 in one or both hips (117/1171). An increasing GMFCS level was strongly associated with an abnormal MP. Hip dislocation was unusual in patients under the age of seven years. A MP of 40 to 99 was not seen in children with isolated dystonia. Displacement was more frequent in children with bilateral involvement and dislocation was only seen in spastic and mixed tone groups. Conclusion This data gives an overview of the number of CP children who have hip displacement/dislocation in Scotland and who will possibly require surgery. Level of Evidence I

scholarly journals Developing a province-wide hip surveillance program for children with cerebral palsy

2019 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Stacey D. Miller ◽  
Tanja A. Mayson ◽  
Kishore Mulpuri ◽  
Maureen E. O’Donnell
Keyword(s):  
Cerebral Palsy ◽  
Surveillance Program ◽  
Children With Cerebral Palsy
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