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Issue title: Hip Disease in Cerebral Palsy
Article type: Research Article
Authors: Kentish, M. | Wynter, M. | Snape, N. | Boyd, R.;
Affiliations: Queensland Cerebral Palsy Health Service, Royal Childrens Hospital, Brisbane, QLD, Australia | Queensland Cerebral Palsy and Rehabilitation Research Centre, The School of Medicine, The University of Queensland, QLD, Australia | Queensland Children's Medical Research Institute, The University of Queensland, QLD, Australia
Note: [] Corresponding author: Megan Kentish, Director, Queensland Cerebral Palsy Health Service, Royal Children's Hospital, Brisbane, QLD 4029, Australia. Tel.: +61 7 36365500; Fax: +61 7 36365480; E-mail: megan_kentish@health.qld.gov.au
Abstract: This study reports the five-year outcomes of a prospective population-based study of clinical hip surveillance for children with cerebral palsy (CP) according to evidence-based standards of care. Systematic hip surveillance commenced in Queensland, Australia as a state-wide program in 2005. Queensland represents a dispersed population across a large geographical area, creating unique challenges in terms of service delivery. Over five years, 1,115 children with CP were recruited, representing 73% of the expected population based on 1.9 to 2.1 per 1,000 live births. Standardized clinical and radiological assessments have been provided, with a median follow-up of 1.2 years (range 1 month −5^{+8} yrs). Of the 1,115 children, 423 (38%) have been discharged and 692 (62%) remain on surveillance with 314 (28%) identified as having hip displacement with Migration Percentage (MP) equal to or greater than 30% (⩾ 30). The incidence of marked hip displacement (MP ⩾ 30) was directly related to gross motor function, classified according to the gross motor function classification system (GMFCS), with distribution of GMFCS I=10, (3%), II=40 (13%), III=53 (43%), IV=96 (59%), and V=115 (64%). This state-wide surveillance program has been successful in correctly identifying children with hip displacement (MP ⩾ 30), fast tracking children for orthopedic review and discharging those at minimal risk. No child has progressed to dislocation while on surveillance without orthopedic review.
Keywords: Hip surveillance, Cerebral Palsy, children, guidelines, standards of care, hip displacement, hip dislocation
DOI: 10.3233/PRM-2011-0176
Journal: Journal of Pediatric Rehabilitation Medicine, vol. 4, no. 3, pp. 205-217, 2011
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