Surveillance measures of the hips of children with bilateral cerebral palsy

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Abstract
In the past, gradual hip subluxation, often leading to dislocation, has often been referred to as ‘developmental dislocation’, but this term has become associated with congenital dislocation of the hip and it is confusing to continue its use in cerebral palsy and similar situations where there is no primary abnormality of the hip joint. The medium to long term consequences of increasing hip deformity are subluxation/dislocation of the hip. Subsequently, loss of hip flexion causes kyphotic sitting with an increased risk of spinal deformity and, in a significant number of children and young adults, nursing/daily living problems increase, often accompanied by hip pain.1 Asymmetrical deformity will cause pelvic obliquity with a greatly increased risk of scoliosis.2 The hip of a child with hemiplegic cerebral palsy appears to avoid this complication, although a child diagnosed as having ‘hemiplegia’, but in reality having a markedly asymmetrical bilateral disorder, can be affected.