[PS15-2C-3] Hip Surveillance for Children with Cerebral Palsy in Resource Limited Countries
Hip dislocation has severe adverse impact on children with cerebral palsy (CP) and their caregivers. Population-based studies in developed countries have reported a significant decrease in the incidence of hip dislocation after implementation of formal hip surveillance programmes. However, implementation of hip surveillance programme in resource limited countries could face numerous challenges. Among them are absence of national CP registry, lack of awareness among primary healthcare providers on the importance of hip surveillance, limited number of paediatric orthopaedic surgeon, and caregiver’s burden and priorities in the care of their child with severe CP. Some important pre-requisites for hip surveillance programme will be presented. They include early diagnosis of CP, routine use of Gross Motor Functional Classification System (GMFCS) to categorise CP, good radiological support, dedicated team with active botulinum toxin injection unit, easy access to paediatric orthopaedic surgeon, good general medical management and caregiver’s support for those with severe CP and on-going audit of the programme. In this lecture, we will share the local experience of a Malaysian center on our hip surveillance programme and proposed management plan when hip displacement is detected. In conclusion, hip surveillance programme is recommended even in resource limited countries, however it needs a coordinated care pathway and should be customized to the local resources.