苏格兰脑瘫儿童总人群中的髋关节移位和脱位。
Hip displacement and dislocation in a total population of children with cerebral palsy in Scotland.
机构信息
Victoria Hospital, Kirkcaldy, UK.
School of Medicine, University of St Andrews, St Andrews, UK.
出版信息
Bone Joint J. 2020 Mar;102-B(3):383-387. doi: 10.1302/0301-620X.102B3.BJJ-2019-1203.R1.
AIMS
The purpose of this study was to compare the prevalence of hip displacement and dislocation in a total population of children with cerebral palsy (CP) in Scotland before and after the initiation of a hip surveillance programme.
PATIENTS
A total of 2,155 children with CP are registered in the Cerebral Palsy Integrated Pathway Scotland (CPIPS) surveillance programme, which began in 2013. Physical examination and hip radiological data are collected according to nationally agreed protocols.
METHODS
Age, Gross Motor Function Classification System (GMFCS) level, subtype of CP, migration percentage (MP), and details of hip surgery were analyzed for all children aged between two and 16 years taken from a time of census in March 2019 and compared to the same data from the initial registration of children in the CPIPS. Displacement of the hip was defined as a MP of between 40% and 99%, and dislocation as a MP of 100%.
RESULTS
A total of 1,646 children were available for analysis at the time of the census and 1,171 at their first registration in CPIPS. The distribution of age, sex, and GMFCS levels were similar in the two groups. The prevalence of displacement and dislocation of the hip before surveillance began were 10% (117/1,171) and 2.5% (29/1,171) respectively, and at the time of the census were 4.5% (74/1,646) and 1.3% (21/1,646), respectively. Dislocation was only seen in GMFCS levels IV and V and displacement seen in 90.5% (67/74) of these levels and 9.5% (7/74) in levels I to III. In total, 138 children had undergone hip surgery during the study period. The hip redisplaced after the initial surgery in 15 children; seven of these had undergone a second procedure and at the time of the census the hips in all seven had a MP < 40.
CONCLUSION
Hip surveillance appears to be effective and has reduced the prevalence of hip displacement by over half and dislocation almost by half in these children. Cite this article: 2020;102-B(3):383-387.
目的
本研究旨在比较苏格兰开展髋关节监测项目前后，脑瘫（CP）患儿总体人群中髋关节移位和脱位的发生率。
患者
CP 综合通路苏格兰（CPIPS）监测项目共登记了 2155 名 CP 患儿，该项目于 2013 年开始。根据全国统一方案收集体格检查和髋关节影像学数据。
方法
分析了 2019 年 3 月普查时所有 2 至 16 岁儿童的年龄、粗大运动功能分类系统（GMFCS）水平、CP 亚型、迁移百分比（MP）和髋关节手术详细信息，并与 CPIPS 首次登记时的相同数据进行比较。髋关节移位定义为 MP 为 40%至 99%，髋关节脱位定义为 MP 为 100%。
结果
普查时共有 1646 名儿童可供分析，首次登记 CPIPS 时共有 1171 名儿童。两组年龄、性别和 GMFCS 水平的分布相似。监测开始前髋关节移位和脱位的发生率分别为 10%（117/1171）和 2.5%（29/1171），普查时分别为 4.5%（74/1646）和 1.3%（21/1646）。脱位仅见于 GMFCS 水平 IV 和 V，90.5%（67/74）见于这些水平，9.5%（7/74）见于水平 I 至 III。在研究期间，共有 138 名儿童接受了髋关节手术。15 名儿童在初次手术后髋关节再次移位，其中 7 名接受了第二次手术，在普查时，这 7 名儿童的髋关节 MP 均<40%。
结论
髋关节监测似乎是有效的，已将儿童髋关节移位的发生率降低了一半以上，髋关节脱位的发生率降低了近一半。
引用本文
2020；102-B（3）：383-387.
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