Page 30 - Delaware Medical Journal - March/April 2019
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FIGURE 1
Proportion of children (%) with migration percentage < 33%, 33%–50%, and > 50% within each Gross Motor Function Classification System level. Data of 53 children were reviewed and the hip with the largest migration percentage was used.
FIGURE 2
Proportion of children (%) with migration percentage < 33%, 33%–50%, and > 50% within each age group. Data of 53 children were reviewed and the hip with the largest migration percentage was used.
FIGURE 3
Thirty-three children, who had at least two radiographs with a minimum one-year interval, were followed for an average of 3.3 years (range 1-8.8 years). was 3.9 and 7.2 years, respectively. and its relation to GMFCS distribution
is shown in Figure 3. Over the follow-
at last evaluation; p=0.41). Considering MP of 8% a true change,9 10 hips had higher MP over time (six of these were Figures 4A-H remaining 17 hips did not show a true MP change. Although AI showed a follow-up (for the same hips with the largest MP, mean of 22 degrees at
evaluation; p=0.04), it was less than 30 degrees for all hips except one that was clearly subluxated with an MP > 60%.
Four patients (three boys and one girl)
in this study had hip reconstruction
(two bilateral and two unilateral). The indication for hip reconstruction was hip subluxation with MP > 50% (Figures 4 and 5). Preoperative hip pain was noted for one patient. Age at surgery was between 5.6 and 9.2 years. Hypotonia underlying diagnosis was known in two patients (Joubert syndrome) and not GMFCS IV and one patient had GMFCS III. Peri-ileal osteotomy was performed
in all four cases. Proximal femoral varus osteotomy was performed in all cases. In the two unilateral cases, proximal femoral varus osteotomy was also performed
on the contralateral side to maintain symmetry for standing and to avoid possible later increased subluxation. Hip measurements improved postoperatively (Table 2). Adductor contracture was found in one case and adductor tenotomy
Proportion of children (%) with migration percentage < 33%, 33%–50%, and > 50% within each Gross Motor Function Classification System level. Data of 33 children, who had at least two radiographs with a minimum one-year interval, were reviewed and the hip with the largest migration percentage was used.
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Del Med J | March/April 2019 | Vol. 91 | No. 2
