Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.25759/spmfr.333 |
Resumo: | Introduction: Our objective was to characterize patients under 18 years old with cerebral palsy (CP), followed in our center, regarding their clinical and functional characterization and the presence of hip deformities, as well as surgical orientations.Material and Methods: Retrospective cross-sectional study based on the files of patients with CP, clinical registers, and serial radiological evaluation of hips according to the Australian Hip Surveillance Program (HSP). Analysis of the group with functional classifications IV and V and characterization of hip deformities: radiological evaluation of the femoral migration index (MI). Subanalysis of patients submitted to orthopedic surgery and patients not submitted to any surgery. The presentation of the results was divided into age groups (1-5 years; 6 – 11 years; 12-18years), according to the coverage of the HSP implemented, in 2012, at our center.Results: Of the total of 285 children with PC, the group with functional levels IV and V had 88 patients. From these group, more than half had subluxation of the hip. Were excluded 30 children. The total non-operated children was 35, the mean MI was 31.6%. The age group of 1-5 years had 3 patients, with a MI of 33.5% and the mean of the last hip radiograph was 7.1 months. The group of 6-11 years had 13 patients, with MI of 32.2%, and the mean of the last radiograph was 11.6 months. The 12-18 years group had 19 patients with a MI of 30.9% and the mean of the last radiograph was 24.5 months. The total operated patients was 23. From these group, 4 were operated before the implementation of the hip surveillance program. After 2012, 19 patients were operated. From these group, 6 were operated with preventive tenotomies and mean of 5 years.Conclusion: About half of the patients with IV and V functional levels had subluxation of the hip. About 38% of these patients have already submitted to surgery. From these group, 1/3 were tenotomies with early ages. Patients who are not surgically treated are under hip surveillance. In this population there is a high prevalence of this hip deformity. However, articulation with orthopedics has allowed early surgical interventions. |
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Hip Surveillance in Patients with Cerebral Palsy: Our Center ExperienceVigilância da Anca em Doentes com Paralisia Cerebral: A Experiência do nosso CentroCerebral Palsy/complications; Child; Hip; Hip Dislocation/prevention & control; Risk AssessmentAnca; Avaliação de Risco; Criança; Luxação da Anca/prevenção e controlo; Paralisia Cerebral/ complicaçõesIntroduction: Our objective was to characterize patients under 18 years old with cerebral palsy (CP), followed in our center, regarding their clinical and functional characterization and the presence of hip deformities, as well as surgical orientations.Material and Methods: Retrospective cross-sectional study based on the files of patients with CP, clinical registers, and serial radiological evaluation of hips according to the Australian Hip Surveillance Program (HSP). Analysis of the group with functional classifications IV and V and characterization of hip deformities: radiological evaluation of the femoral migration index (MI). Subanalysis of patients submitted to orthopedic surgery and patients not submitted to any surgery. The presentation of the results was divided into age groups (1-5 years; 6 – 11 years; 12-18years), according to the coverage of the HSP implemented, in 2012, at our center.Results: Of the total of 285 children with PC, the group with functional levels IV and V had 88 patients. From these group, more than half had subluxation of the hip. Were excluded 30 children. The total non-operated children was 35, the mean MI was 31.6%. The age group of 1-5 years had 3 patients, with a MI of 33.5% and the mean of the last hip radiograph was 7.1 months. The group of 6-11 years had 13 patients, with MI of 32.2%, and the mean of the last radiograph was 11.6 months. The 12-18 years group had 19 patients with a MI of 30.9% and the mean of the last radiograph was 24.5 months. The total operated patients was 23. From these group, 4 were operated before the implementation of the hip surveillance program. After 2012, 19 patients were operated. From these group, 6 were operated with preventive tenotomies and mean of 5 years.Conclusion: About half of the patients with IV and V functional levels had subluxation of the hip. About 38% of these patients have already submitted to surgery. From these group, 1/3 were tenotomies with early ages. Patients who are not surgically treated are under hip surveillance. In this population there is a high prevalence of this hip deformity. However, articulation with orthopedics has allowed early surgical interventions.Introdução: O nosso objetivo foi caracterizar os doentes com paralisia cerebral (PC) abaixo dos 18 anos, seguidos na nossa instituição, relativamente à sua caracterização clínica e funcional e à presença de deformidades da anca, bem como orientações cirúrgicas efetuadas.Material e Métodos: Estudo retrospetivo transversal baseado nos ficheiros de notificação dos doentes com PC, registos clínicos e avaliações radiológicas seriadas da bacia, de acordo com programa de vigilância da anca (PVA) australiano. Análise do grupo com classificações funcionais IV e V e caracterização de deformidades da anca: avaliação radiológica do índice de migração (IM) femoral. Subanálise dos doentes submetidos a cirurgia ortopédica e doentes não intervencionados cirurgicamente. A apresentação dos resultados foi divida em grupos etários (1-5 anos; 6-11 anos, 12-18 anos), consoante a abrangência pelo PVA implementado em 2012, na nossa instituição.Resultados: Do total de 285 crianças com PC, o grupo com níveis funcionais IV e V foi constituído por 88 crianças. Destas, mais de metade apresentaram subluxação da anca. Foram excluídas 30 crianças. O total de crianças não operadas foi de 35, a análise do IM médio foi de 31,6%. O grupo etário dos 1-5 anos foi constituído por 3 doentes, com um IM de 33,5% e a média da última radiografia da bacia há 7,1 meses. O grupo dos 6-11 anos foi constituído por 13 doentes, com IM de 32,2%, e média da última radiografia há 11,6 meses. O grupo dos 12-18 anos foi constituído por 19 doentes, com um IM de 30,9%, e média da última radiografia há 24,5 meses. Dos 23 doentes operados, 4 foram intervencionados antes do início da implementação do PVA. Dos 19 doentes operados após 2012, realizaram-se 6 tenotomias preventivas com média de idade de intervenção aos 5 anos.Conclusão: Cerca de metade dos doentes com níveis funcionais IV e V apresentaram subluxação da anca, dos quais 38% já foram operados e em que num terço foram realizadas tenotomias em idades precoces. Os doentes não intervencionados cirurgicamente estão sob vigilância da anca. Nesta população existe uma prevalência alta desta deformidade da anca. Contudo, a articulação com a Ortopedia tem permitido realizar precocemente intervenções cirúrgicas adequadas.Sociedade Portuguesa de Medicina Física e de Reabilitação2020-06-17T00:00:00Zjournal articlejournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.25759/spmfr.333oai:ojs.spmfrjournal.org:article/333Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação; v. 32, n. 1 (2020): Ano 28; 15-230872-9204reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://spmfrjournal.org/index.php/spmfr/article/view/333https://doi.org/10.25759/spmfr.333https://spmfrjournal.org/index.php/spmfr/article/view/333/191Copyright (c) 2020 Revista da Sociedade Portuguesa de Medicina Física e de Reabilitaçãohttp://creativecommons.org/licenses/by-nc-nd/4.0info:eu-repo/semantics/openAccessAscenso, Diana; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de OrtaMatos, Filipe; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de OrtaFreitas, Margarida; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de OrtaNeves, Ana Sofia; Serviço de Ortopedia e Traumatologia, Hospital Garcia de OrtaEscalda, Carolina; Serviço de Ortopedia e Traumatologia, Hospital Garcia de OrtaAlmeida, Susana; Centro de Desenvolvimento da Criança, Hospital Garcia de OrtaDuarte, Cristina; Centro de Desenvolvimento da Criança, Hospital Garcia de Orta2022-09-20T15:28:41Zoai:ojs.spmfrjournal.org:article/333Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:51:16.084978Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience Vigilância da Anca em Doentes com Paralisia Cerebral: A Experiência do nosso Centro |
title |
Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience |
spellingShingle |
Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience Ascenso, Diana; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta Cerebral Palsy/complications; Child; Hip; Hip Dislocation/prevention & control; Risk Assessment Anca; Avaliação de Risco; Criança; Luxação da Anca/prevenção e controlo; Paralisia Cerebral/ complicações |
title_short |
Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience |
title_full |
Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience |
title_fullStr |
Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience |
title_full_unstemmed |
Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience |
title_sort |
Hip Surveillance in Patients with Cerebral Palsy: Our Center Experience |
author |
Ascenso, Diana; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta |
author_facet |
Ascenso, Diana; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta Matos, Filipe; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta Freitas, Margarida; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta Neves, Ana Sofia; Serviço de Ortopedia e Traumatologia, Hospital Garcia de Orta Escalda, Carolina; Serviço de Ortopedia e Traumatologia, Hospital Garcia de Orta Almeida, Susana; Centro de Desenvolvimento da Criança, Hospital Garcia de Orta Duarte, Cristina; Centro de Desenvolvimento da Criança, Hospital Garcia de Orta |
author_role |
author |
author2 |
Matos, Filipe; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta Freitas, Margarida; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta Neves, Ana Sofia; Serviço de Ortopedia e Traumatologia, Hospital Garcia de Orta Escalda, Carolina; Serviço de Ortopedia e Traumatologia, Hospital Garcia de Orta Almeida, Susana; Centro de Desenvolvimento da Criança, Hospital Garcia de Orta Duarte, Cristina; Centro de Desenvolvimento da Criança, Hospital Garcia de Orta |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Ascenso, Diana; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta Matos, Filipe; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta Freitas, Margarida; Serviço de Medicina Física e de Reabilitação, Hospital Garcia de Orta Neves, Ana Sofia; Serviço de Ortopedia e Traumatologia, Hospital Garcia de Orta Escalda, Carolina; Serviço de Ortopedia e Traumatologia, Hospital Garcia de Orta Almeida, Susana; Centro de Desenvolvimento da Criança, Hospital Garcia de Orta Duarte, Cristina; Centro de Desenvolvimento da Criança, Hospital Garcia de Orta |
dc.subject.por.fl_str_mv |
Cerebral Palsy/complications; Child; Hip; Hip Dislocation/prevention & control; Risk Assessment Anca; Avaliação de Risco; Criança; Luxação da Anca/prevenção e controlo; Paralisia Cerebral/ complicações |
topic |
Cerebral Palsy/complications; Child; Hip; Hip Dislocation/prevention & control; Risk Assessment Anca; Avaliação de Risco; Criança; Luxação da Anca/prevenção e controlo; Paralisia Cerebral/ complicações |
description |
Introduction: Our objective was to characterize patients under 18 years old with cerebral palsy (CP), followed in our center, regarding their clinical and functional characterization and the presence of hip deformities, as well as surgical orientations.Material and Methods: Retrospective cross-sectional study based on the files of patients with CP, clinical registers, and serial radiological evaluation of hips according to the Australian Hip Surveillance Program (HSP). Analysis of the group with functional classifications IV and V and characterization of hip deformities: radiological evaluation of the femoral migration index (MI). Subanalysis of patients submitted to orthopedic surgery and patients not submitted to any surgery. The presentation of the results was divided into age groups (1-5 years; 6 – 11 years; 12-18years), according to the coverage of the HSP implemented, in 2012, at our center.Results: Of the total of 285 children with PC, the group with functional levels IV and V had 88 patients. From these group, more than half had subluxation of the hip. Were excluded 30 children. The total non-operated children was 35, the mean MI was 31.6%. The age group of 1-5 years had 3 patients, with a MI of 33.5% and the mean of the last hip radiograph was 7.1 months. The group of 6-11 years had 13 patients, with MI of 32.2%, and the mean of the last radiograph was 11.6 months. The 12-18 years group had 19 patients with a MI of 30.9% and the mean of the last radiograph was 24.5 months. The total operated patients was 23. From these group, 4 were operated before the implementation of the hip surveillance program. After 2012, 19 patients were operated. From these group, 6 were operated with preventive tenotomies and mean of 5 years.Conclusion: About half of the patients with IV and V functional levels had subluxation of the hip. About 38% of these patients have already submitted to surgery. From these group, 1/3 were tenotomies with early ages. Patients who are not surgically treated are under hip surveillance. In this population there is a high prevalence of this hip deformity. However, articulation with orthopedics has allowed early surgical interventions. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-06-17T00:00:00Z |
dc.type.driver.fl_str_mv |
journal article journal article info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25759/spmfr.333 oai:ojs.spmfrjournal.org:article/333 |
url |
https://doi.org/10.25759/spmfr.333 |
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oai:ojs.spmfrjournal.org:article/333 |
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por |
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por |
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https://spmfrjournal.org/index.php/spmfr/article/view/333 https://doi.org/10.25759/spmfr.333 https://spmfrjournal.org/index.php/spmfr/article/view/333/191 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2020 Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação http://creativecommons.org/licenses/by-nc-nd/4.0 info:eu-repo/semantics/openAccess |
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Copyright (c) 2020 Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação http://creativecommons.org/licenses/by-nc-nd/4.0 |
eu_rights_str_mv |
openAccess |
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Sociedade Portuguesa de Medicina Física e de Reabilitação |
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Sociedade Portuguesa de Medicina Física e de Reabilitação |
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Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação; v. 32, n. 1 (2020): Ano 28; 15-23 0872-9204 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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