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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 5, 720-726.
doi: 10.1302/0301-620X.84B5.12398  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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Hip surveillance in children with cerebral palsy

IMPACT ON THE SURGICAL MANAGEMENT OF SPASTIC HIP DISEASE

F. Dobson, BAppSc (PT), PGDip HlthRes, Research Physiotherapist; R. N. Boyd, MSc PT PGDip Biomech, Senior Research Physiotherapist; J. Parrott, BAppSc (PT), Research Physiotherapist; G. R. Nattrass, MD, FRCS C, FRACS, Consultant Orthopaedic Surgeon; and H. K. Graham, MD, FRCS Ed, FRACS, Professor

Orthopaedic Department and Hugh Williamson Gait Laboratory, Royal Children’s Hospital, Flemington Road, Parkville 3052, Victoria, Australia.

Correspondence should be sent to Professor H. K. Graham.

We studied prospectively the impact of a hip surveillance clinic on the management of spastic hip disease in children with cerebral palsy in a tertiary referral centre. Using a combination of primary clinical and secondary radiological screening we were able to detect spastic hip disease at an early stage in most children and to offer early surgical intervention. The principal effect on surgical practice was that more preventive surgery was carried out at a younger age and at a more appropriate stage of the disease. The need for reconstructive surgery has decreased and that for salvage surgery has been eliminated. Displacement of the hip in children with cerebral palsy meets specific criteria for a screening programme. We recommend that hip surveillance should become part of the routine management of children with cerebral palsy. The hips should be examined radiologically at 18 months of age in all children with bilateral cerebral palsy and at six- to 12-monthly intervals thereafter. A co-ordinated approach by orthopaedic surgeons and physiotherapists may be the key to successful implementation of this screening programme.




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G. S. Gordon and D. E. Simkiss
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Prevention of dislocation of the hip in children with cerebral palsy: THE FIRST TEN YEARS OF A POPULATION-BASED PREVENTION PROGRAMME
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General