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KMID : 1140920180420020277
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Annals of Rehabilitation Medicine
2018 Volume.42 No. 2 p.277 ~ p.285
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Determinants of Hip and Femoral Deformitiesin Children With Spastic Cerebral Palsy
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Cho Yoo-Na
Park Eun-Sook
Park Han-Kyul
Park Jae-Eun
Rha Dong-Wook
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Abstract
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Objective: To find factors affecting hip and femoral deformities in children with spastic cerebral palsy (CP) bycomparing various clinical findings with imaging studies including plain radiography and computed tomography(CT) imaging.
Methods: Medical records of 709 children with spastic CP who underwent thorough baseline physical examinationand functional assessment between 2 to 6 years old were retrospectively reviewed. Fifty-seven children (31 boysand 26 girls) who had both plain radiography of the hip and three-dimensional CT of the lower extremities at least5 years after baseline examination were included in this study.
Results: The mean age at physical examination was 3.6 years (SD=1.6; range, 2?5.2 years) and the duration offollow-up imaging after baseline examination was 68.4 months (SD=22.0; range, 60?124 months). The migrationpercentage correlated with motor impairment and the severity of hip adductor spasticity (R1 angle of hipabduction with knee flexion). The femoral neck and shaft angle correlated with the ambulation ability and severityof hip adductor spasticity (R1 and R2 angles of hip abduction with both knee flexion and extension).
Conclusion: Hip subluxation and coxa valga deformity correlated with both dynamic spasticity and shorteningof hip adductor muscles. However, we found no correlation between femoral deformities such as femoralanteversion, coxa valga, and hip subluxation.
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KEYWORD
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Cerebral palsy, Coxa valga, Hip dislocation, Bone anteversion, Muscle spasticity
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