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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 11, 1492-1496.
doi: 10.1302/0301-620X.88B11.18114  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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A systematic review of the evidence for hip surveillance in children with cerebral palsy

G. S. Gordon, MBChB, DCH, MRCP(UK), MSc, MRCPCH, Consultant Community Paediatrician1; and D. E. Simkiss, BMedSci, MBChB, DCH, DTMH, MRCP(UK), MSc, MRCPCH, Senior Lecturer in Child Health Health Sciences Research Institute2

1 Child Health Centre, Hospital Road, Bury St Edmunds, Suffolk IP33 3ND, UK.
2 Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.

Correspondence should be sent to Dr D. E. Simkiss; e-mail: d.e.simkiss{at}warwick.ac.uk

We reviewed the evidence for hip surveillance in children with cerebral palsy from the published literature.

Publications were identified using the Cochrane controlled trials register, the MEDLINE, EMBASE and CINAHL databases and by hand searching key journals and their references. Studies were included if they reported the frequency, associated risk factors or surveillance measures undertaken to identify subluxation or dislocation of the hip in children with cerebral palsy. Assessment of the quality of the methodology was undertaken independently by two researchers.

Four studies described the natural history, incidence and risk factors for dislocation of the hip. Two reported their surveillance results. Approximately 60% of children who were not walking by five years of age were likely to develop subluxation of the hip, with the greatest risk in those with severe neurological involvement. The introduction of surveillance programmes allowed earlier identification of subluxation and reduced the need for surgery on dislocated hips.

Surveillance can identify children most at risk of subluxation using radiological methods which are widely available.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General