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Verification of the Robin and Graham classification system of hip disease in cerebral palsy using three‐dimensional computed tomography
Author(s) -
GOSE SHINICHI,
SAKAI TAKASHI,
SHIBATA TORU,
AKIYAMA KEISUKE,
YOSHIKAWA HIDEKI,
SUGAMOTO KAZUOMI
Publication year - 2011
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2011.04130.x
Subject(s) - cerebral palsy , medicine , gross motor function classification system , acetabulum , sagittal plane , radiography , computed tomography , nuclear medicine , femur , orthodontics , anatomy , radiology , surgery , physical therapy
Aim We evaluated the validity of the Robin and Graham classification system of hip disease in cerebral palsy (CP) using three‐dimensional computed tomography in young people with CP. Method A total of 91 hips in 91 consecutive children with bilateral spastic CP (57 males, 34 females; nine classified at Gross Motor Function Classification System level II, 42 at level III, 32 at level IV, and eight at level V; mean age 5y 2mo, SD 11mo; range 2–6y) were investigated retrospectively using anteroposterior plain radiographs and three‐dimensional computed tomography (3D‐CT) of the hip. The migration percentage was calculated on plain radiographs and all participants were classified into four groups according to migration percentage: grade II, migration percentage ≥10% but ≤ 15%, (four hips), grade III, migration percentage >15% but ≤30%, (20 hips); grade IV, migration percentage >30% but <100%, (63 hips); and grade V, migration percentage ≥100%, (four hips). The lateral opening angle and the sagittal inclination angle of the acetabulum, the neck–shaft angle, and the femoral anteversion of the femur were measured on 3D‐CT. Results The three‐dimensional quantitative evaluation indicated that there were significant differences in the lateral opening angle and the neck–shaft angle between the four groups (Kruskal–Wallis test, p ≤0.001). Interpretation This three‐dimensional evaluation supports the validation of the Robin and Graham classification system for hip disease in 2‐ to 7‐year‐olds with CP.