Are sitting devices really helpful for hip dislocation in patients with spastic cerebral palsy?

Abstract

Introduction: Sitting devices are used worldwide for disabled children. Given that flexed hip and increased spasticity are likely risk factors for hip dislocation, it is highly probable that sitting devices may aggravate hip dislocation. Therefore, we aimed to identify whether sitting devices aggravate hip dislocation. Methods: In this retrospective case-control study, a total of 42 R-bank patients and 34 control subjects diagnosed with cerebral palsy were included for analysis. R-bank patients used a sitting device, while control subjects did not. By radiographic images, Reimers migration index, lateral center edge angle, femur neck shaft angle, and Cobbs angle were measured. We compared the demographic data, clinical variables, and radiographs between two groups. Results: In the R-bank group, there was significant deterioration in the Reimers migration index, from 26.89% to 44.18% after using the device (p<0.001). The progression of migration index was 14.72 % and 7.82 % per year in the R-bank group and control group, respectively (p=0.02). Conclusion: Sitting devices with an abductor bar in patients with cerebral palsy may exacerbate hip dislocation. Therefore, we should pay attention to the benefits and risks of a sitting device more carefully.