Definition of hip displacement and dislocation by acetabular dysplasia in children with cerebral palsy.

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-08-01 DOI:10.1177/18632521231185294
Nai Kuang Wang, Shih Hsien Shen, Brian Po Jung Chen, Chia Hsieh Chang, Ken N Kuo
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Abstract

Purpose: The acetabulum interacts with the femoral head in daily activities and may exhibit structural changes in the presence of hip disorders. This study aims to redefine hip disorders in children with cerebral palsy by structural characteristics of the acetabulum in relation to the degree of the migration percentage.

Methods: The clinical and radiographic data of 70 patients (36 males, 34 females; mean age 8.2 years) with spastic cerebral palsy were retrospectively analyzed. The acetabular structure was measured by the acetabular index on reconstructed three-dimensional computerized tomography for precision of measurement. Any significant change in acetabular index measured on the reconstructive computerized tomography related to every 10% increment of migration percentage was regarded as clinically significant in hip disorders.

Results: The acetabular index measured on the reconstructive computerized tomography showed an increasing trend with the increment of migration percentage. The most significant acetabular index measured on the reconstructive computerized tomography change occurred between the 20%-29% and 30%-39% migration percentage groups (p < 0.001), suggesting that a migration percentage of 30% is the starting point of hip disorder. A significant increase in the posterolateral acetabular index measured on the reconstructive computerized tomography occurred in migration percentages >50%, indicating posterolateral acetabular dysplasia. Hips with migration percentages from 80% to 100% had consistent acetabular indexes measured on the reconstructive computerized tomography values, suggesting complete dislocation and no more contact and interaction between the femoral head and acetabular fossa.

Conclusion: Structural characteristics in the acetabulum reflect hip dysfunction and potentially classify hip disorders. Results suggest the migration percentage 30% as a starting point of hip disorder and 80% as a turning point of hip dislocation in children with cerebral palsy.

Level of evidence: level IV, diagnostic study.

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脑瘫患儿髋臼发育不良引起髋关节移位和脱位的定义。
目的:髋臼在日常活动中与股骨头相互作用,在出现髋关节疾病时可能表现出结构变化。本研究旨在通过髋臼的结构特征与移位百分率的关系来重新定义脑瘫儿童的髋关节疾病。方法:70例患者的临床及影像学资料(男36例,女34例;对痉挛型脑瘫患者的平均年龄8.2岁进行回顾性分析。采用重建三维计算机体层摄影的髋臼指数测量髋臼结构,以保证测量精度。髋臼指数在重建计算机断层扫描上每增加10%的移动百分比,就会有显著的变化,这被认为是髋关节疾病的临床意义。结果:重建ct测量的髋臼指数随迁移率的增加呈上升趋势。重建计算机断层扫描测量的最显著的髋臼指数变化发生在20%-29%和30%-39%迁移百分比组(p为50%),表明髋臼后外侧发育不良。在重建的计算机断层扫描值上,移动百分比从80%到100%的髋关节髋臼指数一致,表明完全脱位,股骨头和髋臼窝之间不再接触和相互作用。结论:髋臼的结构特征反映了髋关节功能障碍,并可能对髋关节疾病进行分类。结果表明,在脑瘫儿童中,30%的迁移率为髋关节疾病的起点,80%为髋关节脱位的转折点。证据等级:IV级,诊断性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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