Skip to the content

Proximal femoral geometry in cerebral palsy: A population-based cross-sectional study

Robin, J, Graham, H, Selber, P, Dobson, F, Smith, K and Baker, RJ 2008, 'Proximal femoral geometry in cerebral palsy: A population-based cross-sectional study' , Journal of Bone and Joint Surgery - British Volume, 90-B (10) , pp. 1372-1379.

[img] PDF - Published Version
Restricted to Repository staff only

Download (592kB) | Request a copy

    Abstract

    There is much debate about the nature and extent of deformities in the proximal femur in children with cerebral palsy. Most authorities accept that increased femoral anteversion is common, but its incidence, severity and clinical significance are less clear. Coxa valga is more controversial and many authorities state that it is a radiological artefact rather than a true deformity. We measured femoral anteversion clinically and the neck-shaft angle radiologically in 292 children with cerebral palsy. This represented 78% of a large, population-based cohort of children with cerebral palsy which included all motor types, topographical distributions and functional levels as determined by the gross motor function classification system. The mean femoral neck anteversion was 36.5° (11° to 67.5°) and the mean neck-shaft angle 147.5° (130° to 178°). These were both increased compared with values in normally developing children. The mean femoral neck anteversion was 30.4° (11° to 50°) at gross motor function classification system level I, 35.5° (8° to 65°) at level II and then plateaued at approximately 40.0° (25° to 67.5°) at levels III, IV and V. The mean neck-shaft angle increased in a step-wise manner from 135.9° (130° to 145°) at gross motor function classification system level I to 163.0° (151° to 178°) at level V. The migration percentage increased in a similar pattern and was closely related to femoral deformity. Based on these findings we believe that displacement of the hip in patients with cerebral palsy can be explained mainly by the abnormal shape of the proximal femur, as a result of delayed walking, limited walking or inability to walk. This has clinical implications for the management of hip displacement in children with cerebral palsy.

    Item Type: Article
    Themes: Health and Wellbeing
    Schools: Colleges and Schools > College of Health & Social Care
    Colleges and Schools > College of Health & Social Care > School of Health Sciences
    Journal or Publication Title: Journal of Bone and Joint Surgery - British Volume
    Publisher: British Editorial Society of Bone and Joint Surgery
    Refereed: Yes
    ISSN: 0301-620X
    Depositing User: RH Shuttleworth
    Date Deposited: 08 Jun 2011 09:23
    Last Modified: 20 Aug 2013 17:53
    URI: http://usir.salford.ac.uk/id/eprint/15944

    Actions (login required)

    Edit record (repository staff only)

    Downloads per month over past year

    View more statistics