The purpose of this study was to examine the prevalence of hip displacement and its association with Gross Motor Function Classification System and type of cerebral palsy. Specifically this study aimed to evaluate clinical indicators for hip displacement and contribute to the evidence based hip surveillance guidelines for early detection of hip displacement.
This cross sectional study included 173 children aged 2 to 16 years with different levels of GMFCS and type of cerebral palsy using convenience sampling. Data were collected from hip radiographs and clinical information including age, GMFCS and type of CP were recorded. The hip migration percentages were calculated by Reimer's migration percentage from the hip radiographs. Hip with migration percentage of 30 or more was considered as hip displacement. Hip with migration percentage of 100 was considered as hip dislocation. Chi square test was used to find out the association between hip displacement, GMFCS and the different types of cerebral palsy.
Out of 173 children, 63 (36.4%) children were having hip displacement with migration percentages of 30 or more. 11 children (6.4 %) were found to have hip dislocations with migration percentages of 100. There was no hip displacement in GMFCS I, (5.6%) in GMFCS II, while it was significantly more (46.8%) in GMFCS III, (74.1%) in GMFCS IV and (89.5%) in GMFCS V. Hip displacement was more common in children with quadriplegia (77.8%) and dystonia (46.2%) while it was less common (13.8%) in diplegic and (15.8%) in hemiplegic type of CP.
This study found a high prevalence of hip displacement especially in children with a higher level of GMFCS. The prevalence was also high in children with quadriplegia and dystonia. These findings emphasize the importance of hip screening for displacement especially in children with a higher level of GMFCS. Based on the level of GMFCS a regular schedule of clinical examinations and hip radiographs can help in early detection of hip displacement which could facilitate its timely management to prevent hip dislocations and further complications.
The results of this study have very important clinical implications for the early detection of hip displacement in children with cerebral palsy. Regular hip screening should be a priority especially for children with a higher level of GMFCS and children with quadriplegia and dystonia to allow for early intervention and prevent progression of hip displacement to dislocation. The findings reinforce the need for clinical practice guidelines for hip surveillance and shows the significance of future research on the development of standard screening protocols and to investigate the effectiveness of early intervention for hip displacement in children with cerebral palsy.
Hip displacement
GMFCS
