Hip Dysplasia in Congenital Zika Syndrome: A 5 Year Follow-Up

Abstract

Background: Children with Congenital Zika Syndrome (CZS) usually have severe neurological impairment with extrapyramidal involvement mainly spastic quadriplegia, so we believe they would have the same spasticity-related abnormalities, such as high prevalence of hip subluxation, as children with other aetiologies of cerebral palsy (CP). The aim of this study was to investigate hip status and describe the radiographic measures, Reimer's migration percentage (MP) and acetabular index (AI) in infants diagnosed with CZS.Methods: 29 infants with CZS's medical records and pelvis' radiography were analysed. 22 patients had consecutive exams taken for comparison. The sample was divided into two groups, in the first group, X-rays were obtained from children aged 24 months or younger, in the second group, X-rays were obtained from the same children aged more than 24 months, a second measure. Results:The mean MP was 24.7% and AI was 27.4° for the right hip, 21.4% and 27.4° for the left hip in the first group. The mean MP was 53.2% and AI was 27.4° for the right hip, 53.9% and 26.8° for the left hip, in the second measure. MP was statically different for the first and second measures (p = 0.001), AI was not statically different (p > 0.44). Conclusion:AI was abnormal in children 2-years-old and younger, there was a high femoral head migration and hip subluxation in children older than 2 years, the changes were bilateral and symmetrical; thus hip surveillance should be used for the follow-up of patients with CZV.