Validity and Reliability of Measuring Femoral Anteversion and Neck-Shaft Angle in Patients with Cerebral Palsy

Chung, Chin Youb; Lee, Kyoung Min; Park, Moon Seok; Lee, Sang Hyeong; Choi, In Ho; Cho, Tae-Joon

doi:10.2106/jbjs.i.00688

Cited by 76 publications

(73 citation statements)

References 32 publications

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“…Without controlling for the moderating effects of gross motor function, the association between femoral deformities and hip displacement cannot be clearly defined. Another problem is that measurement of femoral deformities, as seen on radiographs, could be affected by profound contracture and malposture in children with cerebral palsy who are nonambulatory [8,16]. With advancements in computerized image processing techniques, three-dimensional (3-D) CT has been proposed as a superior method to measure femoral deformities in children with cerebral palsy [1,4,7,11,13,18,23,32,34,35].…”

Section: Introductionmentioning

confidence: 99%

Determinants of Hip Displacement in Children With Cerebral Palsy

Chang

Wang

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Coxa valga and femoral anteversion often are seen in patients with spastic hip displacement and osteotomy is recommended. However, the relationship between femoral deformities and hip displacement has not been clearly defined and other factors, such as joint motion and posture, should be considered before recommending treatment. Questions For children with cerebral palsy with Gross Motor Function Classification System Level IV or V, we questioned (1) whether hip abduction range correlates with hip displacement, (2) what the relationships are between proximal femoral deformities and hip displacement, and (3) whether the patient with a windblown posture has greater degrees of femoral anteversion? Methods We retrospectively studied 31 consecutive children with cerebral palsy with Level IV or V gross motor function who underwent three-dimensional CT for preoperative assessment of hip displacement between January 2010 and December 2013. Among the children, 23 had a windblown posture and eight had symmetric hip motion. Femoral anteversion and true neck-shaft angle were measured from the three-dimensional CT images. Migration percentage was the dependent variable we chose to study in relation to femoral anteversion, neck-shaft angle, maximal hip abduction, and hip flexion contracture, using correlations and multiple linear regressions. Using ANOVA and Scheffé's post hoc tests, we analyzed and compared the data of 23 abducted hips and 23 adducted hips in the 23 children with windblown posture and in 16 displaced hips in the eight children with symmetric hip abduction. Results Greater migration percentage was associated with less hip abduction range (r = À0.86; p \ 0.001). Femoral anteversion had a weak correlation (r = 0.28; p \ 0.05) to migration percentage, and the association became insignificant after considering hip abduction motion. Adducted windblown hips had greater femoral anteversion

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Section: Introductionmentioning

confidence: 99%

Determinants of Hip Displacement in Children With Cerebral Palsy

Chang

Wang

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…In general, the reliability of the neck-shaft angle has been shown to be good. A recent study of patients with cerebral palsy showed an overall intraobserver and interobserver reliability of neck-shaft-angle measurements on hip radiographs of 0.929 and 0.912, respectively 18 . Marmor et al found that neck-shaft-angle measurements varied <5°w ith <35°of limb rotation, and the measurements were always greater than the true value 19 .…”

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confidence: 99%

Association of Atypical Femoral Fractures with Bisphosphonate Use by Patients with Varus Hip Geometry

Hagen

Miller

Ott

et al. 2014

The Journal of Bone and Joint Surgery

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“…They found good inter & intra observer reliability in their methodology. Many western authors also observed good inter observer correlation in measuring NSA [31,32].…”

Section: Resultsmentioning

confidence: 86%