From the Department of Orthopedics, Alfred I. duPont Hospital for Children, Wilmington, DE (Dr. Shrader), the Texas Scottish Rite Hospital for Children, Dallas, TX (Dr. Wimberly), and the Orthopedic Institute for Children, University of California in Los Angeles, Los Angeles, CA (Dr. Thompson).
J Am Acad Orthop Surg. 2019 Oct 15;27(20):760-768. doi: 10.5435/JAAOS-D-18-00184.
Hip dysplasia is common in children with cerebral palsy (CP), especially in those children with notable functional impairment. Severity of hip dysplasia has been shown to correlate with higher Gross Motor Function Classification System levels. Migration percentage measured on AP pelvis radiographs is the key radiographic measure quantifying hip displacement in CP. Hip surveillance programs for children with CP exist in Europe, Australia, and parts of Canada and have been adopted as standard of care. These programs have demonstrated improved detection of hip subluxation and appropriate early intervention with a resultant decrease in the number of painful dislocations. Hip surveillance programs provide healthcare providers with guidance for a schedule of obtaining hip radiographs based on patients' age, Gross Motor Function Classification System level, and migration percentage. Although systematic surveillance programs have yet to be adopted in the United States, several centers and organizations are currently investigating the potential and efficacy of hip screening in CP.
髋关节发育不良在脑瘫(CP)儿童中很常见,尤其是那些功能明显受损的儿童。髋关节发育不良的严重程度与更高的粗大运动功能分类系统水平相关。在前后骨盆 X 光片上测量的迁移百分比是量化 CP 中髋关节移位的关键放射学测量指标。欧洲、澳大利亚和加拿大部分地区存在针对 CP 儿童的髋关节监测计划,并已被采纳为标准护理。这些计划已证明可以提高髋关节半脱位的检出率,并进行适当的早期干预,从而减少疼痛性脱位的数量。髋关节监测计划为医疗保健提供者提供了根据患者的年龄、粗大运动功能分类系统水平和迁移百分比获得髋关节 X 光片的时间表指导。尽管系统的监测计划尚未在美国采用,但目前有几个中心和组织正在研究 CP 中髋关节筛查的潜力和效果。