Pelvic obliquity and measurement of hip displacement in children with cerebral palsy

Hägglund, Gunnar; Goldring, Mikael; Hermanson, Maria; Rodby‐Bousquet, Elisabet

doi:10.1080/17453674.2018.1519104

Cited by 15 publications

(13 citation statements)

References 13 publications

(15 reference statements)

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“…The presence of PO should be recorded in hip surveillance programmes. One way to account for the PO is to measure the pelvic adjusted MP (PAMP) [16].…”

Section: Discussionmentioning

confidence: 99%

Association between pelvic obliquity and scoliosis, hip displacement and asymmetric hip abduction in children with cerebral palsy: a cross-sectional registry study

Hägglund

2020

BMC Musculoskelet Disord

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Background: Pelvic obliquity (PO) is common in individuals with cerebral palsy (CP). The prevalence of PO in a population of children with CP and its associations with scoliosis, hip displacement and asymmetric range of hip abduction were analysed. Methods: Over a 5-year period all pelvic radiographs from the Swedish surveillance programme for CP and the recorded data for scoliosis and hip abduction in children from southern Sweden at Gross Motor Function Classification System (GMFCS) levels II-V were analysed. PO and hip displacement calculated as migration percentage (MP) were measured on supine pelvic radiographs and compared with presence of scoliosis and side difference in hip abduction. Statistical analyses comprised chi-squared and binominal testing. Results: In total, 337 children were analysed, of whom 79 had a PO of ≥5°. The proportion of children with PO increased from 16% in GMFCS level II to 34% in level V. Scoliosis combined with PO was reported in 38 children, of whom 34 (89%, 95% confidence interval [CI] 80-99%) had the convexity opposite to the high side of the PO. Asymmetric abduction with PO was reported in 45 children, of whom 40 (89%, CI 79-99%) had reduced abduction on the high side of the PO. Asymmetric MP of ≥5% with PO was seen in 62 children, of whom 50 had higher MP on the high side of the PO (81%, CI 71-90%). Children in GMFCS levels II-IV more often had isolated infra-pelvic association with PO (47% versus 19% in GMFCS V, P = 0.025), while combined supra-and infrapelvic association was more common in GMFCS level V (65% versus 30% in GMFCS II-IV, P = 0.004). Isolated infrapelvic or no association was seen in 74% of children ≤10 years of age while 76% of children ≥11 years old had suprapelvic or combined supra-and infrapelvic association with PO (P < 0.001). Conclusions: There was a strong association between the high side of the PO and the side of scoliosis, highest MP, and lowest range of abduction when PO was measured in supine position. PO was more often associated with infrapelvic factors. PO was seen in young children indicating the need for early awareness of this complication.

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“…The presence of PO should be recorded in hip surveillance programmes. One way to account for the PO is to measure the pelvic adjusted MP (PAMP) [16].…”

Section: Discussionmentioning

confidence: 99%

Association between pelvic obliquity and scoliosis, hip displacement and asymmetric hip abduction in children with cerebral palsy: a cross-sectional registry study

Hägglund

2020

BMC Musculoskelet Disord

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“…The presence of PO should be recorded in hip surveillance programmes. One way to account for the PO is to measure the pelvic adjusted MP (PAMP) [15].…”

Section: Discussionmentioning

confidence: 99%

Association between Pelvic Obliquity and Scoliosis, Hip Displacement and Asymmetric Hip Abduction in Children with Cerebral Palsy. A Cross-Sectional Registry Study

Hägglund¹

2020

Preprint

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Background Pelvic obliquity (PO) is common in individuals with cerebral palsy (CP). I analysed the prevalence of PO in a population of children with CP and its associations with scoliosis, hip displacement and asymmetric range of hip abduction.Methods Over a 5-year period all pelvic radiographs from the Swedish surveillance programme for CP and the recorded data for scoliosis and hip abduction in children from southern Sweden at Gross Motor Function Classification System (GMFCS) levels II–V were analysed. PO and hip displacement calculated as migration percentage (MP) were measured on supine pelvic radiographs and compared with side difference in hip abduction. Statistical analyses comprised chi-squared testing and binominal confidence intervals.Results In total, 337 children were analysed, of whom 79 had a PO of ≥5°. The proportion of children with PO increased from 16% in GMFCS level II to 34% in level V. Scoliosis combined with PO was reported in 38 children, of whom 34 (89%, 95% confidence interval [CI] 80–99%) had the convexity opposite the high side of the PO. Asymmetric abduction with PO was reported in 45 children, of whom 40 (89%, CI 79–99%) had reduced abduction on the high side of the PO. Asymmetric MP of ≥5% with PO was seen in 62 children, of whom 50 had higher MP on the high side of the PO (81%, CI 71–90%). Children in GMFCS levels II–IV more often had isolated infra-pelvic association with PO (47% versus 19% in GMFCS V, P = 0.025), while combined supra- and infrapelvic association was more common in GMFCS level V (65% versus 30% in GMFCS II–IV, P = 0.004). Isolated infrapelvic or no association was seen in 74% of children ≤10 years of age while 76% of children ≥11 years old had suprapelvic or combined supra- and infrapelvic association with PO (P = 0.0001).Conclusions There was a strong association between the high side of the PO and the side of scoliosis, highest MP and lowest range of abduction when PO was measured in supine position. PO was more often associated with infrapelvic factors. PO was seen in young children indicating the need for early awareness of this complication.

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“…All measurements were performed by two orthopedic surgeons. The migration percentage ( 15 ) and pelvic obliquity ( 16 ) were measured on pelvic radiographs at the initial and last follow-up. Hip subluxation requiring reconstructive surgery was defined according to the current literature as migration percentage >30%, and hip dislocation was defined as migration percentage of 100% ( 17 , 18 ).…”

Section: Methodsmentioning

confidence: 99%

Point Prevalence and Associated Factors of Hip Displacement in Pediatric Patients With Mitochondrial Disease

et al. 2021

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Objective: Mitochondrial disease is a multisystem disorder resulting from mitochondrial dysfunction. Although musculoskeletal system is vulnerable to mitochondrial dysfunction, little information is available on orthopedic issues such as hip displacement and scoliosis in patients with mitochondrial disease. We aimed to examine the point prevalence of hip displacement and investigate the associated factors in patients with mitochondrial disease.Methods: We retrospectively reviewed the medical records and plain radiographs of patients diagnosed with mitochondrial disease between January 2006 and January 2019 at a single institution. Data, including patient age, sex, follow-up duration, syndromic diagnosis, and gross motor function were collected. Migration percentage was measured on the radiographs. The clinical and radiologic variables were compared between patients classified according to the presence of hip displacement and motor function level.Results: We included 225 patients (135 men, 90 women). The mean age at the latest follow-up was 11.1 years, and the mean follow-up duration was 7.0 years. Hip displacement was noted in 70 (31.1%) patients. The proportion of patients with Leigh disease (p = 0.007) and the ratio of non-ambulators (p < 0.001) were higher among patients with hip displacement. The proportion of patients with Leigh disease was higher in the non-ambulators than the ambulators.Conclusion: One-third of patients with mitochondrial disease developed hip displacement. Hip displacement was more common in non-ambulators or patients with hypertonia. Careful and serial monitoring for hip problems is required for non-ambulatory patients with mitochondrial disease who have increased muscle tone.

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Pelvic obliquity and measurement of hip displacement in children with cerebral palsy

Cited by 15 publications

References 13 publications

Association between pelvic obliquity and scoliosis, hip displacement and asymmetric hip abduction in children with cerebral palsy: a cross-sectional registry study

Association between pelvic obliquity and scoliosis, hip displacement and asymmetric hip abduction in children with cerebral palsy: a cross-sectional registry study

Association between Pelvic Obliquity and Scoliosis, Hip Displacement and Asymmetric Hip Abduction in Children with Cerebral Palsy. A Cross-Sectional Registry Study

Point Prevalence and Associated Factors of Hip Displacement in Pediatric Patients With Mitochondrial Disease

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