Hip migration percentage in children with cerebral palsy treated with botulinum toxin type A

Pidcock FS, Fish DE, Johnson-Greene D, Borras I, McGready J, Silberstein CE. Hip migration percentage in children with cerebral palsy treated with botulinum toxin type A. Objective To determine hip radiographic findings in children with cerebral palsy (CP) treated with botulinum toxin type A (BTX-A). Design Retrospective chart review with correlation to radiographic findings. Setting Academic center. Participants Sixteen subjects with CP. Intervention BTX-A treatment to adductor muscles. Main outcome measure The Reimers hip migration percentage before and after BTX-A. Results Thirty-two hips in 16 children with CP were treated. We examined the effect of initial migration percentage and initial migration percentage age on the change in migration percentage after BTX-A injection. A significant effect for initial migration percentage ( 24mo) was not significant (F=.95, P=.34). Patients who had an initial migration percentage of 30% or more and were less than 24 months old were more likely to have a decrease in migration percentage after BTX-A injection compared with patients who were older than 24 months and who had an initial migration percentage of 30% or more. Conclusions Improvement in hip migration percentage after BTX-A injection is a function of age and the initial migration percentage. BTX-A injections to adductor muscles may be beneficial for some children with CP.