Incidence and degree of hip subluxation/dislocation in children with spinal cord injury.
OBJECTIVE
The purpose of this study was to verify the incidence and degree of hip subluxation/dislocation in children with spinal cord injury (SCI) and determine the association between age of injury and hip subluxation/dislocation.


METHODS
All children from our SCI database with complete data through 2001, who had follow-up of > 2 years and were at least 14 years of age at follow-up, were included in the study. Hip subluxation was defined as a migration index (MI) > 20%. The medial joint space (MJS) was measured and considered abnormal if > 7 mm. The patients were divided into 2 groups: those < or = 10 years of age at the time of injury (group 1) and those > 10 years of age (group 2). There were 62 patients included in the study: 29 in group 1 and 33 in group 2. The mean age at the time of injury was 4.6 years for group 1 and 14.3 years for group 2.


CONCLUSIONS
Forty-eight percent of patients had at least one hip with subluxation/dislocation: 93% in group 1 and 9% in group 2. The mean MI (for those that were abnormal) was 44% in group 1 and 25% in group 2. The MJS was abnormal in 78% of hips in group 1 and 38% in group 2. Thirteen patients in group 1 and 1 patient in group 2 underwent surgery to better contain the hip. Numerous other radiographic hip irregularities were identified. This study demonstrates a high rate of hip subluxation/dislocation in children with SCI who had onset of injury before 10 years of age.
McCarthy
James J
JJ
Shriners Hospitals for Children, Philadelphia, Pennsylvania 19140, USA. JMcCarthy@shrinenet.org
Chafetz
Ross S
RS
Betz
Randal R
RR
Gaughan
John
J
D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D015994:Incidence; D017746:Joint Capsule / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications*