Problem: Hip instability in cerebral palsy is a very common problem and occurs because of muscular imbalance. It includes hip subluxation/dislocation, acetabular dysplasia with or without joint degeneration & femoral head deformity. The incidence of Hip dysplasia is high in quadriplegic & non-ambulatory children. So it is very important to have a high suspicion of hip dislocation in these children which can be identified at a very early stage
Management Protocol: Spasticity of the adductor longus is the primary cause of hip dysplasia. We can reduce the chances of hip instability by doing adductor tenotomy. Patients with acetabular dysplasia need acetabular reorientation osteotomy. Hip dislocation needs open reduction along with corrective osteotomy of the femur & acetabulum. Correction of all contractures & deformities also needs to be done during this surgery (SEMLS).
