One common orthopaedic condition that can occur in children with cerebral palsy is Hip Displacement. Hip displacement commonly occurs in children who are not walking but it can also occur in some children who are walking.
Why does Hip Displacement Occur?
We are all born with shallow hip sockets and the position of the head of femur (ball of the hip joint) is positioned more loosely within the socket. The normal development of gross motor skills and the pull of muscles shape the immature skeletal system into an adult skeletal system, resulting in a firm ball and socket hip joint. This is why children are at risk of hip displacement and should be under an orthopaedic surgeon to monitor their hip joints as they grow.
How Can We Monitor Hip Displacement?
Your physiotherapist can assess your child’s hips regularly but it is important that your child has an X-ray every year to closely monitor their hips. Whilst the X-ray is taken, it is important that the child is positioned correctly and that measurements are taken in line with hip surveillance guidelines. Ideally your child should be under the care of an orthopaedic consultant and/or physiotherapist trained to measure the hip X-ray.
Why is it Important to Monitor Hips?
It is very important to monitor your child’s hips from an early age as displacement can become painful and early surgical treatment at an optimal time tends to be less invasive and more successful. Hip displacement especially (if it is painful) can also lead to stiffness at the hip joint, a reduction in joint motion resulting in asymmetric sitting, which can further drive the formation of spinal curves (scoliosis).
Take Home Message.
The Association of Paediatric Chartered Physiotherapists recommends that hip surveillance should begin in early childhood with a baseline X-ray carried out at 30 months. If there are clinical concerns identified by your physiotherapist, the X-ray should occur earlier. If your child’s hip migration percentage (measured from the X-ray) is less than 15% then your child should continue with annual check X-rays. If greater than 15%, your child should be monitored every 6 months. If the migration percentage is greater than 30% or has increased by 7% since the last check X-ray, your child should see the orthopaedic doctor.
Are you looking for a specialist paediatric physio to see your child? Our specialist paediatric physios are able to see your child at home and we can usually arrange the first appointment within 24 hours. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.