Abstract
Cerebral palsy (CP) is the most frequent cause of chronic orthopedic disorders in children. Hip dysplasia occurs secondary to delayed walking and excessive muscle tone. The hip flexors and adductors overpower the hip extensors and abductors causing the femoral head to pull out of socket, most commonly in a posterolateral direction. Children with CP should be evaluated on a regular basis – both clinically and radiographically. Walking by 30 months significantly lowers the child’s risk of hip problems. An anteroposterior pelvis radiograph is used to assess for hip subluxation. A young patient with an at-risk hip (Migration Index <30%) should undergo a soft-tissue operation. If subluxation is significant, a varus derotation osteotomy is indicated along with a soft-tissue operation. If the acetabulum is dysplastic, then an acetabuloplasty is also indicated. For chronic non-reducible painful hips, a salvage operation should be considered.
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Hellman, M.D., Root, L., Kogan, M. (2022). Neuromuscular Hip Disorders: Focus on Cerebral Palsy. In: Nho, S.J., Bedi, A., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-43240-9_42
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