Borowski Andrzej, Kwapisz Adam, Grzegorzewski Andrzej, Synder Marek
Orthopaedics and Paediatric Orthopaedics Department, Medical University of Łódź, Poland.
Ortop Traumatol Rehabil. 2010 Jul-Aug;12(4):320-8.
Disturbed muscle balance in the hip joints of children with cerebral palsy (CP) shifts the pivoting point from the middle of the femoral head to the lesser trochanter. Forces that dislocate the femoral head progressively change acetabular shape, producing inadequate femoral head covering. The aim of the study was to carry out a radiological evaluation of hip congruency in children with CP after surgical treatment.
The study group consisted of CP patients operated on due to lower limb dysfunction between 1988 and 2001. All patients had undergone multilevel soft tissue release. A total of 52 children reported for follow-up examinations. There were 18 patients with hemiparesis (32%), 19 with diparesis (36%), and 15 with tetraparesis (29%). The age at surgery was between 2 and 19 y.o. (average age 7.33 y.o.). Radiological evaluation of the hip joints focused on changes in the migration index and the shaft-neck angle.
The mean migration index before surgery was 30.4% in the group of diparetic and tetraparetic children. At the last follow-up examination, the average migration index was 32.5% on the right side and 25.6% on the left side (p>0.05). There was a statistically significant decrease in the value of the migration index in children operated on before the age of 8 years (p=0.007). In children operated on after the age of 8, the change in the migration index value did not exceed 0.5% (p>0.05).
脑瘫（CP）患儿髋关节肌肉平衡失调会使枢轴点从股骨头中部转移至小转子。导致股骨头脱位的力量会逐渐改变髋臼形状，致使股骨头覆盖不足。本研究的目的是对接受手术治疗的CP患儿的髋关节吻合情况进行放射学评估。
研究组由1988年至2001年间因下肢功能障碍接受手术的CP患者组成。所有患者均接受了多级软组织松解术。共有52名儿童前来接受随访检查。其中偏瘫患儿18例（32%），双瘫患儿19例（36%），四肢瘫患儿15例（29%）。手术年龄在2至19岁之间（平均年龄7.33岁）。髋关节的放射学评估重点在于移位指数和股骨干颈角的变化。
双瘫和四肢瘫患儿组术前平均移位指数为30.4%。在最后一次随访检查时，右侧平均移位指数为32.5%，左侧为25.6%（p>0.05）。8岁前接受手术的患儿移位指数值有统计学意义的下降（p=0.007）。8岁后接受手术的患儿，移位指数值变化不超过0.5%（p>0.05）。
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