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Spastic hip dysplasia in severe cerebral palsy: Review from the literature

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Defense Thèse de privat-docent : Univ. Genève, 2016
Abstract Cerebral palsy is a neurodevelopmental condition that could be secondary to hypoxic–ischaemic brain injury during the perinatal period of development or congenital anomalies. Cerebral palsy is the most frequent cause of physical disability in development countries. These patients have motor impairment and also a high rate of mental health problems. Their motor impairments developed unbalanced hip contractures that can lead to silent hip dislocation. The incidence of this complication can be very high, from 15% to 60% (1). There is a relationship with the degree of physical disability and hip dislocation (2). Non-walking patients have a high chance to develop this deformity. The pathogenesis of the progressive hip subluxation from the acetabulum is related to muscular imbalance around the hip. They usually have strong adductors and flexors and unbalanced weak abductors and extensors. The natural history of the hip dislocation can develop pain, contractures and difficulties with hygiene. Surveillance programmes in cerebral palsy patients can help in detecting at-risk patients for hip dislocation, and early recognition enables early appropriate interventions. The surveillance should be performed with regular radiographic hip examination; because physical examination alone is not a reliable method to mesure hip dislocation . Most physicians agree that preventing hip dislocation is a good way to prevent future problems with hip pain and contracture, providing benefits to the family, caregivers and patient (2). Surgical and rehabilitative approaches, such as soft tissue lengthening and proximal femoral and pelvic osteotomies, can help to maintain hip reduce into the acetabulum. The rationale of this review is to evaluate recent literature for current trends in the surveillance and treatment of spastic hip problems in patients with cerebral palsy.
Keywords Hip dysplasiaCerebral PalsyPainSpasticity
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DE COULON, Geraldo. Spastic hip dysplasia in severe cerebral palsy: Review from the literature. Université de Genève. Thèse de privat-docent, 2016. https://archive-ouverte.unige.ch/unige:87922

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Deposited on : 2016-10-04

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