The Windsweep Index: A method of evaluating pelvic asymmetry and monitoring the efficacy of treatment in cerebral palsy

Progressive asymmetry of the pelvis is frequently observed in total body involved cerebral palsy (CP) children, when opposite contractures and deformities affect the two sides of the body. This asymmetry is important in terms of difficulty in standing and seating stability and if untreated can lead to bilateral dislocation of the hip. The visual term 'Windsweep' has been used to describe this deformity. We present an equation to determine the extent of this asymmetry - the 'Windsweep' Index (WSI). This can be used as a numerical assessment of the deformity and to assess the efficacy of treatment

Total hip arthroplasty in skeletal dysplasia

This study presents the results of 38 hip prostheses in 24 people of short stature (under 152 cm). A retrospective clinical and radiological study recording the diagnosis, age at reconstruction, height, weight, type of prostheses, length of follow-up, radiological appearances and patient satisfaction was performed. Harris hip scores were used to assess activities of daily living. All patients were under 152cm and their diagnoses included achondroplasia, spondyloepiphyseal dysplasia, multiple epiphyseal dysplasia, developmental dysplasia of the hip and juvenile chronic arthritis. The mean height of these patients was 135 cm (range: 109cm to 150cm). The mean age was 38 years (range: 19 to 75 years) with mean follow-up 67 months (range: 12 to 406 months). Only one patient, who is now aged 69 years (though 65 years at revision surgery), has required revision surgery to date. The results were excellent for 33 hips (Harris hip score between 80-100), good in three (Harris hip score between 70-80), satisfactory in one (score 60-70) and poor for one (Harris hip score <50). The mean Harris hip score to date is 89. Hip replacement surgery is difficult in this challenging group of patients but can nonetheless yield gratifying results in over 90% of cases