One of the questions that parents ask us most often refers to the hip dislocation in children with cerebral palsy. How have hip problems in children with cerebral palsy become a major issue?
Parents are very concerned about this problem and their anxiety is growing because most orthopedic surgeons tell them that their child is a definite candidate for hip surgery.
Hip problems – approach to the problem
The problem of hip dislocation is, unfortunately, presented to parents as a matter of priority, i.e. that surgical intervention will certainly be necessary for their child and that it is only a matter of moments, and that it is, therefore, necessary to take some urgent measures. In an artificial way, parental attention is directed to this issue and the panic button is activated. By the way, similar increased anxiety and concern are also caused by the varus or valgus foot position problems.
To solve the problem of hip dislocation, parents are offered an operation called an osteotomy. It is usually explained that this operation is necessary for two main reasons:
- because of the prognosis that if the above surgery is not performed, the child will experiance hip pain in the future;
- due to the likelihood that an incorrectly located femoral head may press the blood vessels and thus lead to tissue necrosis (dying) over time. That is to say, even if the child does not have these symptoms, surgery as a preventive measure will certainly be recommended.
The only plausible diagnostic indicator of whether the child will be a candidate for osteotomy surgery is the angle between the femoral head and the hip that is seen on the X-ray. However, we can say that there is virtually no child with cerebral palsy who has the right angle between the head of the femur and joint, i.e. according to textbooks and established diagnostic procedures, all children with cerebral palsy need hip surgery, especially when it comes to the conditions corresponding to Level 3 to 5 on the GMFCS scale.
The standard approach practically provides no other way of correcting this problem and the operation is presented as the only way out. However, I would like to point out that this approach and the viewpoint can be wrong, and I would also like to help you think of the necessary steps that can allow you to come closer to solving this problem in a non-invasive way that encourages development.
