Development of a wearable orthotic device pattern to prevent hip dislocation in children with cerebral palsy

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hyunjung Han ◽  
Jeong Ha Kim
Keyword(s):  
Cerebral Palsy ◽  
Great Trochanter ◽  
Hip Dislocation ◽  
Virtual Model ◽  
Persons With Disabilities ◽  
Content Type ◽  
Final Version ◽  
Orthotic Device ◽  
Children With Cerebral Palsy ◽  
Child Patient

PurposeThis study suggest the development of a wearable orthotic device pattern that can reduce pain and deformation, and help in the normal development of children with cerebral palsy. Such a pattern enables daily wear before hip subluxation occurs, to prevent hip dislocation and subluxation.Design/methodology/approachThis study set the design line by carrying out cell work on the actual model, then proceeded with the first pattern design. The final version of the second orthotic device was designed by conducting discussions with experts and the patient's guardian, with the device fitted to the child patient. The evaluation of the second orthotic device used the virtual model to check the pressure area and level through virtual fitting. An evaluation was then conducted with the device fitted to the child patient, to verify the functionality and suitability of the final pattern.FindingsFollowing the initial fitting evaluation, the second pattern was presented after modifying and supplementing issues such as movement suitability with posture change, position change of the great trochanter when wearing a diaper, pressure control of the X-shaped band on the genital area and thigh abduction. The master pattern of the final version of the second orthotic device was proposed after confirming that the femoral head of the hip joint was stably fixed, and the compression was applied through a verification based on the virtual fitting using the virtual model, and with the device fitted to the child patient.Originality/valueWith this study, it is expected that the process and design plan for the development of wearable orthotic device patterns for the persons with disabilities impaired mobility can be used as a basic resource to create devices that merge the clothing and medical fields.

scholarly journals Evaluation of the effectiveness of screening and monitoring program for early prevention of orthopedic complications in children with cerebral palsy

2020 ◽  
Vol 64 (6) ◽  
pp. 79-83
Author(s):  
V. A. Zmanovskaya ◽  
E. V. Kashuba ◽  
R. I. Valeev ◽  
O. Yu. Ezhov
Keyword(s):  
Cerebral Palsy ◽  
Monitoring Program ◽  
Motor Impairment ◽  
Hip Dislocation ◽  
Preventive Treatment ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Surveillance Program ◽  
Children With Cerebral Palsy ◽  
Hip Luxation

Hip instability and following hip luxation and subluxations remain common and serious problem among children with cerebral palsy (CP). The hip luxation and subluxations can be avoided using timely monitoring and early preventive treatment. However, standard scheme for patients’ management in children with CP is not adopted so far in Russian Federation. In 2014 on the territory of Tyumen region the Europe surveillance program for children with CP (CPUP) was introduced.Research purpose. To analyze the effectiveness of the early orthopedic complications prevention program in children with CP. Material and methods. The study included children with CP of the «Child psychoneurological medical-rehabilitation center «Nadezhda» register born in 2010 and earlier (n=176), undergoing surveillance under the European Program (main group); the comparison group consisted of children with CP which were treated before the adoption of the program (n=642). Group comparability was achieved by selecting children with one level of motor impairment according to the GMFCS classification. The presence of expressed orthopedic complications was exposed at the value of Reimers Index (RI) above 40%, and the effectiveness of the program was determined by a reduction in the frequency of such RI.Results. It was found that overall incidence of hip dislocation in control group decreased by 70%: in children with GMFCS II by 100%, GMFCS III – by 78%, GMFCS IV – by 62% and GMFCS V – by 74%.Conclusion. Due to the introduction of the Europe surveillance program on the territory of Tyumen region there is a significant decrease in orthopedic complications incidence in children with CP.

Anterior Hip Dislocation in Children with Cerebral Palsy

1998 ◽  
Vol 18 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Giuseppe Selva ◽  
Freeman Miller ◽  
Kirk W. Dabney
Keyword(s):  
Cerebral Palsy ◽  
Hip Dislocation ◽  
Children With Cerebral Palsy ◽  
Anterior Hip Dislocation

scholarly journals Hip displacement in children with cerebral palsy in Scotland: a total population study

2018 ◽  
Vol 12 (6) ◽  
pp. 635-639 ◽  
Author(s):  
K. E. Bugler ◽  
M. S. Gaston ◽  
J. E. Robb
Keyword(s):  
Cerebral Palsy ◽  
Total Population ◽  
Hip Dislocation ◽  
Level Of Evidence ◽  
Surveillance Programme ◽  
Hip Displacement ◽  
Number Of Children ◽  
Children With Cerebral Palsy ◽  
Migration Percentage ◽  
Gmfcs Level

Purpose The purpose of this study is to report the number of children from a total population of children with cerebral palsy (CP) in Scotland who had a displaced or dislocated hip at first registration in a national surveillance programme. Methods Migration percentage (MP), laterality, Gross Motor Function Classification System (GMFCS) level, CP subtype, distribution of CP and age were analyzed in 1171 children. Relative risk was calculated with 95% confidence intervals. Hip displacement and dislocation were defined as a MP of 40 to 99 and > 100 respectively. Results Radiographs were available from the first assessment of 1171 children out of 1933 children registered on the system. In all, 2.5% of children had either one or both hips dislocated (29/1171) and dislocation only occurred in children of GMFCS levels IV and V. A total of 10% of children had a MP 40 to 99 in one or both hips (117/1171). An increasing GMFCS level was strongly associated with an abnormal MP. Hip dislocation was unusual in patients under the age of seven years. A MP of 40 to 99 was not seen in children with isolated dystonia. Displacement was more frequent in children with bilateral involvement and dislocation was only seen in spastic and mixed tone groups. Conclusion This data gives an overview of the number of CP children who have hip displacement/dislocation in Scotland and who will possibly require surgery. Level of Evidence I

scholarly journals Cost-effectiveness analysis of a surveillance program to prevent hip dislocation in children with cerebral palsy

2020 ◽  
Vol 34 (4) ◽  
pp. 377-384 ◽  
Author(s):  
Laura Vallejo-Torres ◽  
Amado Rivero-Santana ◽  
Carlos Martin-Saborido ◽  
David Epstein ◽  
Lilisbeth Perestelo-Pérez ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Cost Effectiveness ◽  
Hip Dislocation ◽  
Cost Effectiveness Analysis ◽  
Surveillance Program ◽  
Effectiveness Analysis ◽  
Children With Cerebral Palsy

scholarly journals Reconstruction surgery for dislocated hips in children with cerebral palsy

2021 ◽  
Vol 27 (4) ◽  
pp. 481-486
Author(s):  
D.A. Popkov ◽  
◽  
G.M. Chibirov ◽  
A.D. Tomov Tomov ◽  
◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Hip Dislocation ◽  
Holistic Approach ◽  
Optimal Time ◽  
Long Term Outcomes ◽  
Hip Reconstruction ◽  
Reconstruction Surgery ◽  
Children With Cerebral Palsy ◽  
Orthopaedic Society

Introduction The article is a literature review focusing on reconstruction surgery for dislocated hips in children with cerebral palsy (CP). Material and methods Publications in Scopus, PubMed, RSCI indexed journals over the past 20 years were reviewed for hip dislocation in children with CP. Results and discussion The article discusses the prevalence of the orthopaedic complication of cerebral palsy, pathogenesis, diagnosis, indications to surgery, choice of surgical technique, early rehabilitation and long-term outcomes. A report made for the first educational meeting of the European Pediatric Orthopaedic Society held in Russia at the Ilizarov Center in 2021 was used for the contribution. Conclusion Surgical treatment is indicated for hip dislocation in children with CP using holistic approach and principles of single-event multilevel surgery that suggest hip reconstruction, addressing contractures and deformities of the subjacent segments and creating conditions for postoperative postural management. Standardized indications, patient selection and optimal time for intervention are to be carefully considered for the procedure with the use of customized orthopaedic implants and techniques.

scholarly journals Cerebral palsy with dislocated hip and scoliosis: what to deal with first?

2020 ◽  
Vol 14 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Ilkka J. Helenius ◽  
Elke Viehweger ◽  
Rene M. Castelein
Keyword(s):  
Cerebral Palsy ◽  
Early Identification ◽  
Hip Dislocation ◽  
Pelvic Obliquity ◽  
Neuromuscular Scoliosis ◽  
Function Score ◽  
Hip Reconstruction ◽  
Surveillance Programme ◽  
Children With Cerebral Palsy ◽  
Similar Programme

Purpose Hip dislocation and scoliosis are common in children with cerebral palsy (CP). Hip dislocation develops in 15% and 20% of children with CP, mainly between three and six years of age and especially in the spastic and dyskinetic subtypes. The risk of scoliosis increases with age and increasing disability as expressed by the Gross Motor Function Score. Methods A hip surveillance programme and early surgical treatment have been shown to reduce the hip dislocation, but it remains unclear if a similar programme could reduce the need for neuromuscular scoliosis. When hip dislocation and neuromuscular scoliosis are co-existent, there appears to be no clear guidelines as to which of these deformities should be addressed first: hip or spine. Results Hip dislocation or windswept deformity may cause pelvic obliquity and initiate scoliosis, while neuromuscular scoliosis itself leads to pelvic obliquity and may increase the risk of hip dislocation especially on the high side. It remains unclear if treating imminent hip dislocation can prevent development of scoliosis and vice versa, but they may present at the same time for surgery. Current expert opinion suggests that when hip dislocation and scoliosis present at the same time, scoliosis associated pelvic obliquity should be corrected before hip reconstruction. If the patient is not presenting with pelvic obliquity the more symptomatic condition should be addressed first. Conclusion Early identification of hip displacement and neuromuscular scoliosis appears to be important for better surgical outcomes.

scholarly journals Derotational Subtrochanteric Osteotomy and External Fixation for the Treatment of Neurogenic Hip Dislocation in Children with Cerebral Palsy: Could This Be a Viable Method of Treatment?

Cureus ◽  
2020 ◽  
Author(s):  
Stavros Angelis ◽  
Georgios Vynichakis ◽  
Angelos Trellopoulos ◽  
Alexandros Apostolopoulos ◽  
Dimitrios Filippou ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
External Fixation ◽  
Hip Dislocation ◽  
Children With Cerebral Palsy ◽  
Viable Method

Gait before and 10 years after rhizotomy in children with cerebral palsy spasticity

1998 ◽  
Vol 88 (6) ◽  
pp. 1014-1019 ◽  
Author(s):  
Nivedita Subramanian ◽  
Christopher L. Vaughan ◽  
Jonathan C. Peter ◽  
Leila J. Arens
Keyword(s):  
Cerebral Palsy ◽  
Healthy Volunteers ◽  
Video Data ◽  
Spastic Diplegia ◽  
Selective Dorsal Rhizotomy ◽  
Content Type ◽  
Dorsal Rhizotomy ◽  
Normal Limits ◽  
Children With Cerebral Palsy ◽  
Fine Print

Object. Selective dorsal rhizotomy is a neurosurgical procedure performed for the relief of spasticity in children with cerebral palsy, but its long-term functional efficacy is still unknown. The authors sought to address this issue by means of an objective, prospective study in which quantitative gait analysis was used. Methods. Eleven children with spastic diplegia (mean age at initial surgery 7.8 years) were evaluated preoperatively in 1985 and then at 1, 3, and at least 10 years after surgery. For comparison, 12 age-matched healthy individuals were also studied. Retroreflective targets were placed over the hip, knee, and ankle joints, and each individual's gait was videotaped. The video data were subsequently entered into a computer for extraction and analysis of the gait parameters. An analysis of variance yielded a significant time effect (p < 0.05), and post hoc comparisons revealed differences before and after surgery and with respect to the healthy volunteers. The knee and hip ranges of motion (59° and 44°, respectively, for healthy volunteers) were significantly restricted in children with spastic diplegia prior to surgery (41° and 41°, respectively), but were within normal limits after 10 years (52° and 45°, respectively). The knee and hip midrange values (31° and 3°, respectively, for healthy volunteers), indicative of posture, were significantly elevated preoperatively (42° and 15°) and increased sharply at 1 year (56° and 18°), but by 10 years they had decreased to within normal limits (36° and 9°). Step length and velocity improved postoperatively but were not within the normal range after 10 years. Ten years after surgery these patients not only had increased ranges of motion, but also used that movement at approximately a normal midrange point. Conclusions. Selective dorsal rhizotomy is an effective method for alleviating spasticity. Furthermore, the authors provide evidence to show that lasting functional benefits, as measured by improved gait, can also be obtained.

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