Verticalisation en abduction de hanches pour la prévention de l’excentration de hanche chez l’enfant paralysé cérébral

Abstract

Hip eccentricity (EH) is a common musculoskeletal deformity in children with cerebral palsy (CP), with severe and multiple consequences. The risk of EH increases with young age, functional limitation, spasticity, and if the condition is quadriplegic. Prevention of EH is therefore a public health issue from an early age. The standing program with hip abduction (VAH) is commonly used for this purpose, but it is highly controversial. Based on a review of the literature and external sources, only seven clinical trials in relation to the subject were found. There is a great disparity in methodology between the articles. VAH may have an effect on EH in children with CP, both preventively and after soft tissue surgery, but the level of evidence is moderate. This device seems to be more effective if the management is more comprehensive. Younger age and less advanced CP are indications where VAH seems to be effective, especially when started early. Confirming this effect with larger numbers is necessary as well as studying the long-term effect, especially in adolescence.