The Value Of X-ray Measurement In Development Of Hip Joint In Children With Cerebral Palsy

Objective To explore the sensitive indicators of hip development in patients with cerebral palsy,and to find a suitable method of detecting secondary hip dysplastic in children with cerebral palsy.Methods A total of 103 children with cerebral palsy(206 hips)aged from 1 to 4 who were admitted to our hospital for the first time between October 2017 and October 2019 were selected,and evaluated the Gross Motor Function Classification System(GMFCS)of the included children.All children received standardized hip radiographs and X-ray related indexes were measured.Measures included migration percentage(MP),acetabular index(AI),neck shaft angle(NSA)and head shaft angle(HSA).And 46 children of the same age group were taken as the control group,including 92 hips.Stratified by age,all children were divided into three groups: < 2 years old,2 ~ 3 years old(?2 years old,?3 years old)and > 3 years old.The differences of relevant measurement indexes between the group of children with cerebral palsy and the group of normal children in different age groups were compared,and then single-factor and multi-factor regression analysis was conducted to analyze the influence of age,gender,HSA,NSA and Gross Motor Function Classification System on MP of children with cerebral palsy,taking MP value as the dependent variable.Results The comparison of hip X-ray related indicators between CP group and normal group aged under 2 showed that there were no significant differences in AI,NSA,MP and HSA of pelvic radiographs.Compared with normal children aged from 2 to 3,the relative indexes of hip joint X-ray showed that NSA in the CP group was 144.73±9.46°,while that in the normal group was 137.90±2.93°,the MP in the CP group was 19.78±13.70%,that in the normal group was 6.53± 5.08%,the HSA in the CP group was 165.68±7.03°,while that in the normal group was 160.14±2.50°.And there was no significant difference in AI between the two groups.Compared with the normal children and children with cerebral palsy aged over 3,the relevant indicators of hip X-ray showed that the NSA in the CP group was 144.81±9.03°,while the normal group was 133.50±6.41°,the MP in the CP group was 20.58± 10.70%,while the normal group was 10.83± 6.40%,the HSA in the CP group was 166.34±6.50°,and the normal group was 158.16±4.56°.There was no significant difference in AI between the two groups.Single-factor regression analysis and multi-factor regression analysis showed that gender and NSA had no significant effect on MP in children with cerebral palsy,while HSA,age and GMFCS were significantly correlated with MP.Conclusion 1.In the X-ray measurement of hip joint in children with cerebral palsy,NSA?MP and HSA are all effective indicators to reflect the abnormal development of hip joint.2.Age,Gross Motor Function Classification System and HSA are all risk factors affecting hip development in children with cerebral palsy.And Clinicians can routinely monitor hip MP and HSA in clinical work in children with cerebral palsy,so as to detect and timely intervene secondary hip dysplasia in children with cerebral palsy.