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Erschienen in: Journal of Children's Orthopaedics 2/2008

01.03.2008 | Original Clinical Article

Neurogenic hip dislocation in cerebral palsy: quality of life and results after hip reconstruction

verfasst von: Alexander Krebs, Walter M. Strobl, Franz Grill

Erschienen in: Journal of Children's Orthopaedics | Ausgabe 2/2008

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Abstract

Background

At birth, no difference exists between the hips of children with spastic cerebral palsy and the hips of other children. The typical pathologic deformities of the hips in children with spastic cerebral palsy develop as the child gets older. One of our goals was to evaluate the change in quality of life of children with cerebral palsy after hip reconstruction. For classification of the children’s condition, we assessed sitting and standing abilities and used the Gross Motor Function Classification System. To evaluate the effect of hip dislocation on the spine, we assessed symmetry while the patient was lying down, sitting, and standing.

Methods

The results of surgical reconstruction of hip joints in 54 patients with severe cerebral palsy who had 66 severely subluxated or dislocated hip joints were retrospectively analyzed. The study was based on a research questionnaire with a mean follow-up of 4 years 10 months. The purpose of the questionnaire was to evaluate the pain, functional abilities, symmetry, and independence of the patients by using the modified Barthel index.

Results

Pain was fully relieved in 62 and was eased in 35% of preoperatively painful hips. The functional abilities of sitting and standing were not influenced statistically significantly by the operation. An improvement in sitting symmetry was observed in 40% and improvement in lying symmetry was observed in 32% of the patients. The mean center-edge angle improved from −24.9° ± 39° (mean ± standard deviation) to 25.9° ± 14°. The acetabular index improved from 30.2° ± 8° to 17.1° ± 7°.

Conclusions

The independence of the patients, based on the modified Barthel index, did not change significantly after surgery. Most improvements in quality of life were observed in those patients who had pain in the hip before the operation as a result of reduction of pain and improved mobility of the hip.
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Metadaten
Titel
Neurogenic hip dislocation in cerebral palsy: quality of life and results after hip reconstruction
verfasst von
Alexander Krebs
Walter M. Strobl
Franz Grill
Publikationsdatum
01.03.2008
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Children's Orthopaedics / Ausgabe 2/2008
Print ISSN: 1863-2521
Elektronische ISSN: 1863-2548
DOI
https://doi.org/10.1007/s11832-008-0080-6

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