[Etiopathogenesis of spastic hip pain and dislocation in children].
The hip joint dislocation is one of the most serious complications associated with severe type of spastic cerebral palsy in children. The natural history of this secondary problem is poorly defined: how often and why the dislocated hip joint is going to be painful. The aim of our study was to specify prevalence of hip pain in the quadriplegic spastic type of cerebral palsy children with dislocated one or two hip joints. The next purpose was to establish correlation between cartilage degenerative changes and pain appearance.


METHODS
The clinical study population consisted of cerebral palsy children, who presented a unilateral or bilateral dislocation of the hip joint, operated in Department of Pediatric Orthopedics during the period 2002 through 2005. Performed surgical procedures allowed us to evaluate degenerative changes of femoral head cartilage. In 45 operated hips (33 patients) we discovered that 33 had degenerative cartilage lesions which in 25 cases (75%) were associated with pain appearance.


RESULTS
We observed correlation between anterior location of the femoral head lesion and pain appearance, between the size of the lesion and intensity of pain complaints and also between femoral antetorsion and magnitude of pain.


CONCLUSIONS
Risk factors of pain appearance in spastic dislocated hip joint are degenerative lesions on anterior face of femoral head cartilage, age of the patient, large antetorsion angle and cartilage lesion bigger than 1/4 of femoral head surface.
Jóźwiak
Marek
M
Katedra i Klinika Ortopedii i Traumatologii Dzieciecej, Akademia Medyczna im. Karola Marcinkowskiego w Poznaniu.
Harasymczuk
Piotr
P
Koch
Aleksander
A
Szulc
Andrzej
A
D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006617:Hip Dislocation / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology*; D011044:Poland; D011782:Quadriplegia / Q000150:complications / Q000209:etiology; D012189:Retrospective Studies