The head shaft angle is associated with hip displacement in children at GMFCS levels III-V - a population based study
Abstract
Background: An increased Head Shaft Angle (HSA) has been reported as a risk factor for hip displacement in children with cerebral palsy (CP) but opinions differ in the literature. The purpose of this study was to re-evaluate the relationship between HSA and hip displacement in a different population of children with CP. Methods: The Cerebral Palsy Integrated Pathway Scotland surveillance programme includes 95% of all children with CP in Scotland. The pelvic radiographs from 640 children in GMFCS levels III-V were chosen. The most displaced hip was analysed and the radiographs used were those taken at the child’s first registration in the database to avoid the potential effects of surveillance on subsequent hip centration. A logistic regression model was used with hip displacement (migration percentage [MP] ≥40%) as outcome and HSA, GMFCS, age and sex as covariates. Results: The MP was ≥40% in 118 hips with a mean HSA of 164° (range 121–180°) and < 40% in 522 hips with a mean HSA of 160° (range 111–180°). The logistic regression analysis showed no significant influence of age and sex on MP in this population but a high GMFCS level was strongly associated with hip displacement. An increased HSA was also associated with hip displacement, a 10° difference in HSA for children adjusted for age, sex, and GMFCS gave an odds ratio of 1.26 for hip displacement equal or above 40% (p = 0.009) and hips with HSA above 164.5 degrees had an odds ratio of 1.96 compared with hips with HSA below 164.5 degrees (p = 0.002). Conclusion: These findings confirm that HSA is associated with hip displacement in children in GMFCS levels III-V.
Citation
Finlayson , L , Czuba , T , Gaston , M S , Hägglund , G & Robb , J E 2018 , ' The head shaft angle is associated with hip displacement in children at GMFCS levels III-V - a population based study ' , BMC Musculoskeletal Disorders , vol. 19 , 356 . https://doi.org/10.1186/s12891-018-2275-4
Publication
BMC Musculoskeletal Disorders
Status
Peer reviewed
ISSN
1471-2474Type
Journal article
Rights
Copyright © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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