Detection and treatment of developmental dysplasia of the hip in infants: updates and recommendations.

Purpose Of Review: Developmental dysplasia of the hip (DDH) is common and is a source of potentially avoidable morbidity through childhood and adult life. Despite progress over the past century, there is a wide variation in policy, practice and outcomes between countries. This review considers information from a geographically wide range of locations to evaluate the impact of these variations and understand how these variations arise.

Monitoring of a hip surveillance programme protects infants from radiation and surgical intervention.

Aims: To monitor the performance of services for developmental dysplasia of the hip (DDH) in Northern Ireland and identify potential improvements to enhance quality of service and plan for the future.

Methods: This was a prospective observational study, involving all infants treated for DDH between 2011 and 2017. Children underwent clinical assessment and radiological investigation as per the regional surveillance policy.

The Declining Incidence of Legg-Calve-Perthes' Disease in Northern Ireland: An Epidemiological Study.

Background: Legg-Calve-Perthes' disease (LCPD) is an idiopathic disease of the femoral head affecting the pediatric population. The causative factors remains poorly understood and it is associated with significant hip pathology in adult life. Research has demonstrated wide geographical variation in the incidence rates of LCPD with a relatively high incidence occurring in Northern Ireland (NI) shown in a previous study of incidence from the same unit.

Passive range of motion in a population-based sample of children with spastic cerebral palsy who walk.

While passive range of motion (PROM) is commonly used to inform decisions on therapeutic management, knowledge of PROM of children with spastic cerebral palsy (CP) is limited. A population-based sample of 178 children with spastic CP (110 male; unilateral, n = 94; bilateral, n = 84; age range 4-17 years) and 68 typically developing children (24 male; age range 4-17 years) were recruited to the study. All children were able to walk a minimum of 10 m over a straight flat course, with or without assistive devices.

The time of the insult/triggering event in Legg-Calvé-Perthes' disease determined by incubation period modeling and the age distribution of children with Perthes'.

The time when the insult/triggering event occurs in Legg-Calvé-Perthes' (LCPD) is unknown. the purpose of this study was to determine, using the mathematical tool of incubation period modeling, the time of such event and the incubation period for LCPD. We reviewed 2,911 children with LCPD from 10 different centers around the world.

Age-related changes in energy efficiency of gait, activity, and participation in children with cerebral palsy.

Aim: The aim of this study was to use a prospective longitudinal study to describe age-related trends in energy efficiency during gait, activity, and participation in ambulatory children with cerebral palsy (CP).

Method: Gross Motor Function Measure (GMFM), Paediatric Evaluation of Disability Inventory (PEDI), and Lifestyle Assessment Questionnaire-Cerebral Palsy (LAQ-CP) scores, and energy efficiency (oxygen cost) during gait were assessed in representative sample of 184 children (112 male; 72 female; mean age 10y 9mo; range 4-16y) with CP. Ninety-four children had unilateral spastic CP, 84 bilateral spastic CP, and six had other forms of CP.

Energy efficiency in gait, activity, participation, and health status in children with cerebral palsy.

The aim of the study was to establish if a relationship exists between the energy efficiency of gait, and measures of activity limitation, participation restriction, and health status in a representative sample of children with cerebral palsy (CP). Secondary aims were to investigate potential differences between clinical subtypes and gross motor classification, and to explore other relationships between the measures under investigation. A longitudinal study of a representative sample of 184 children with ambulant CP was conducted (112 males, 72 females; 94 had unilateral spastic C P, 84 had bilateral spastic C P, and six had non-spastic forms; age range 4-17 y; Gross Motor Function Classification System Level I, n=57; Level II, n=91; Level III, n=22; and Level IV, n=14); energy efficiency (oxygen cost) during gait, activity limitation, participation restriction, and health status were recorded.

Recruitment bias in a population-based study of children with cerebral palsy.

Objective: The purpose of this analysis was to assess recruitment bias in a population-based study of locomotor ability in children with cerebral palsy.

Method: A population-based case register was used as a sampling frame and was considered a highly ascertained record of children with the condition. A twin track approach to recruitment for the Locomotor Study was adopted through: (1) a specialist orthopedic service and (2) a community pediatric network on behalf of the case register.

Endocrine profile and physical stature of children with Perthes disease.

Children with Perthes disease have been thought to be of smaller stature than their peers. No reproducible evidence exists to demonstrate an endocrinopathy as the cause. This study reviewed 139 children with Perthes disease.