Abstract
Aims: Instability and dislocation of the hip is one of the most striking problems for children and young people with neuromuscular disorders. The purpose of this study was to find out pathomechanical risk factors relating to specific neuromuscular disorders. We compared our findings with literature and questioned if there is any impact on current screening and treatment principles. Methods: In a prospective long-term-study 2500 patients with neuromuscular disorders regularly underwent analysis of both muscular dysfunction and structural deformities by clinical examination and native radiographs. Walking patients had additional slow motion video-analysis and in the case of surgical intervention pre- and postoperative 3D-gait analysis. The vast majority of patients with the TBI-type of cerebral palsy had unstable hips. 66 severely subluxated or dislocated hip joints underwent 3D-CT-scan examinations prior to surgical reconstruction, soft tissue releases and muscle transfers. Conclusions: Developmental biological studies presume that a complex systemic network of both genetical determining factors and external biomechanical influences affect physiological growth and maturing of the juvenile hip joint. Under clinical condiions it may be possible to discover and analyse some of the most important factors. Primary, compensating and secundary functional disorders have to be differentiated by clinical examination, radiographs, and motion analysis. Increased or spastic and decreased or paretic muscular activity may cause different degrees of muscular imbalance. Together with additional compensating movements they form specific pathological motor patterns which occur typically related to specific neuromuscular diseases.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
