Paralytic dislocation of the hip in children

Abstract

Despite the progress made in the past decades, hip disorders are one of the most common orthopedic problems in the context of paralysis. The etiology can be congenital (malformation such as myelomeningoceles, genetic neuromuscular disorders) or acquired (cerebral palsy, post-traumatic). In these conditions, the orthopedic deformities are minimal at birth. They can develop as the child grows, at different ages, depending on the etiology, severity of the neuromuscular disorder and functional potential. Hip subluxation and dislocation can compromise standing and walking capacities, but also the quality of the seated position and the personal care. Daily life activities and participation are restricted and influence the disabled person's quality of life. Paralytic dislocation of the hip is the orthopedic deformity that has be biggest impact on day-to-day life, general health and the overall orthopedic result in adulthood. Neuro-orthopedic care is challenging. However, there are basic principles that one must know to ensure good long-term quality of life in patients suffering from paralytic dislocations of the hip. When planning the treatment strategy, it is essential to take into consideration the day-to-day life and to integrate the patient's experiences and needs, along with those of their caretakers. The objective of this review is to outline the differences in paralytic dislocations of the hip of diverse etiology, to present evaluation principles useful in daily clinical practice and to help practitioners in choosing a treatment strategy.

Keywords: Children; Hip dislocation; Neurological hip; Outcome evaluation; Paralysis.