Mariana Paredes Barbosa¹* and Margarita Isabel Díaz Sánchez²

¹Medical Specialist in Rehabilitation with High Specialty in Pediatric Rehabilitation Attached to the Department of Physiatry, General Hospital of Zone 8 of the Mexican Institute of Social Security, Mexico
²Medical Specialist in Rehabilitation with High Specialty in Pediatric Rehabilitation Attached to the Injury and Cerebral Palsy Clinic, Telethon Puebla Children's Rehabilitation and Inclusion Center, Paraguay

*Corresponding Author: Mariana Paredes Barbosa, Medical Specialist in Rehabilitation with High Specialty in Pediatric Rehabilitation Attached to the Department of Physiatry, General Hospital of Zone 8 of the Mexican Institute of Social Security, Mexico.

Received: April 26, 2022; Published: June 08, 2022

Abstract

Introduction: In Cerebral Palsy (CP) there is a muscle imbalance that over time affects each of the joints involved and, according to the interventions and ontological factors, the impact will be seen from development to function. Hip displacement is directly related to gross motor function determined by the Gross Motor Function Classification System (SCFMG) and can cause pain that is often difficult to control. Treatment for hip dislocation coxalgia in CP is diverse.

Case Presentation: Here we present the case of an adolescent with coxalgia in which the family rejected the surgical option and after the scarce response to the physiatric and pharmacological management with negative impact on the quality of life and on the burden to the primary caregiver, we opted for drive with radial shock waves.

Discussion: the response to this management was remarkable with remission of the picture during its surveillance at 6 months.

Cerebral palsy (CP) gives muscular imbalance affecting as time goes on each one of articulations; according to ontological the impact will be at developmental and function. Hip displacement is in direct relation with gross motor function delimited by the Gross Motor System Scale and can gives pain, in the most cases difficult to control. Treatment for hip pain secondary to PC is diverse. We present the case of an adolescent with hip pain who his family reject surgical option and, after lacked response to physiatric and pharmacologic methods plus negative impact in the quality of life and charge to caregiver, was treated with radial shockwave. The response was noticeable with remission during surveillance by 6 months.

Keywords: Parálisis Cerebral; Luxación De Cadera; Coxalgia; Ondas De Choque;  Cerebral Palsy; Hip Dislocation; Painful Hip; Shock

References

1. Porter and David. “Patterns of postural deformity in non-ambulant people with cerebral palsy: what is the relationship between the direction of scoliosis, direction of pelvic obliquity, direction of windswept hip deformity and side of hip dislocation?” Clinical Rehabilitation 21 (2007): 1087-1096.
2. Scrutton D., et al. “Hip dysplasia in bilateral cerebral palsy: incidence and natural history in children aged 18 months to 5 years”. Developmental Medicine and Child Neurology 9 (2001): 586-600.
3. Elkamil A., et al. “Prevalence of hip dislocation among children with cerebral palsy in regions with and without a surveillance programme: a cross sectional study in Sweden and Norway”. BMC Musculoskeletal Disorders 12 (2011): 284-290.
4. Hodgkinson I., et al. “Hip pain in 234 non ambulatory adolescents and young adults with cerebral palsy: a cross sectional multicenter study”. Developmental Medicine and Child Neurology 43 (2001): 806-808.
5. Lundy C., et al. “Botulinum toxine type injections can be an effective treatment for pain in children with hip spasms and cerebral palsy”. Developmental Medicine and Child Neurology 51(2009): 705-710.
6. Loew M., et al. “Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder”. Journal of Bone and Joint Surgery 81-B (1991): 863-867.
7. Rompe JD., et al. “Low-energy extracorporeal shock wave therapy for painful hell: a prospective controlled single-blind study”. Archives of Orthopaedic and Trauma Surgery 115 (1996): 75-79.
8. Ruano RA. “Tratamiento con ondas de choque extracorpóreas en ortopedia y rehabilitación. Revisión sistemática”. Axencia de Avaliación de Tecnologías Sanitarias de Galicia (2001).
9. Schmitz C., et al. “Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database”. British Medical Bulletin1 (2015): 115-138.

Citation

Citation: Mariana Paredes Barbosa and Margarita Isabel Díaz Sánchez. “Management of Coxalgia with Shock Waves in an Adolescent with Spastic Cerebral Palsy".Acta Scientific Orthopaedics 5.7 (2022): 26-30.

Copyright

Copyright: © 2022 Mariana Paredes Barbosa and Margarita Isabel Díaz Sánchez. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.