[Hip changes in infantile cerebral palsy]

Abstract

Dislocation of the hip associated with cerebral motor disturbances differs considerably from that in children with normal motor activity. In patients with such disturbances ist is a relatively common and often serious complication. It occurs at an age when there are not usually any clear spastic signs, merely hypotonia with reflex-like movement patterns. Early dislocation is marked by early onset of acetabular dysplasia. In the final analysis, hip dislocation associated with cerebral motor disturbances is attributable to a more or less constant muscle imbalance. The prognosis for hip development is poor if there is an early tendency toward flexion and adduction postures and the course of general motor development is unfavorable. The classification proposed by Tönnis and Brunken (1968) is used for radiological assessment. The primary goal of therapy is to prevent further decentration of the hip joint. Therefore, physiotherapy plays the most important role in early treatment of impending dislocation. All other therapeutic measures are secondary to this.