الفهرس 
Applied anatomy of the hip jointOnly 14 pages are availabe for public view
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Abstract
Summary & recommendations
Cerebral palsy is a well-recognized neurodevelopmental condition beginning in early childhood and persisting through the lifespan. An international workshop in 2007 defined Cerebral Palsy as a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing foetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication and behaviour.(18)
Most patients with cerebral palsy have recognizable patterns of movement that can be classified into spastic, dyskinetic, ataxic, hypotonic & mixed motor types.(2,17,19)
Deformity and displacement of the hip is the second most common orthopaedic problem to affect children with cerebral palsy (after equinus).
These children are born with normal hips. The natural history of the untreated hip in these patients is progressive subluxation associated with bony deformity of the proximal femur and acetabulum, then hip dislocation which can be posterosuperior (common), anterior or inferior. Finally arthritic changes can occur. (26,28,29)
These changes have a bad effect on the quality of life. Pain and loss of the ability to sit comfortably are common problems in up to 50% of patients. Other problems include difficulty with perineal care and personal hygiene, pelvic obliquity and scoliosis, poor sitting balance and loss of the ability to stand and walk.(49)
Close surveillance from age of 1 to 2 years is needed to find the appropriate time for preventive surgery especially in non-ambulators.(66)
Early intervention can be very effective in preventing or delaying the development of dislocation.(3) When hip subluxation occurs, non-operative treatment alone is ineffective. In younger children, soft tissue releases alone may be sufficient, but most patients with hip subluxation require osteotomy in addition to soft tissue release.(89)
A patient with a long-standing dislocation is not a good candidate for a relocation procedure because of the deformities of the proximal femur and acetabulum, which also may be associated with degenerative changes.(4)
The treatment options for these patients are few aiming at improving perineal care & eliminating of pain. (4)
Categories of treatment are:
•Soft tissue release for hip at risk cases or subluxated hips.
•Reduction and reconstruction for subluxated or dislocated hips.
•Salvage surgery for long standing painful dislocations.