{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:55:59Z","timestamp":1792137359741,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:00:00Z","timestamp":1339459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:p><jats:bold>Aim\u2002<\/jats:bold> To study the long\u2010term impact of 3\u2003years of botulinum toxin A (BoNT\u2010A) injections and abduction bracing on hip development in children with bilateral spastic cerebral palsy (CP). We wanted to know if early treatment improved hip development and reduced the need for surgery.<\/jats:p><jats:p><jats:bold>Method\u2002<\/jats:bold> A long\u2010term review of hip morphology and surgery requirements in children who participated in a multicentre, randomized controlled trial. The trial investigated short\u2010term effects of BoNT\u2010A injections combined with an abduction brace, compared with usual care, on hip displacement in children with bilateral spastic CP.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Forty\u2010six children with bilateral spastic CP (31 males, 15 females; 10 with diplegia, 36 with quadriplegia; mean age at enrolment of 3y 2mo, mean age at most recent clinical review 13y 11mo [range 10y 6mo\u201316y 8mo]; three children in Gross Motor Function Classification System level II, 11 in level III, 20 in level IV, 12 in level V) were followed for a mean of 10\u2003years 10\u2003months from recruitment to the trial. Mean migration percentage was 15.9% in the BoNT\u2010A group and 15.2% in the comparison group (<jats:italic>t<\/jats:italic>=0.26, <jats:italic>p<\/jats:italic>=0.79). Eighty\u2010nine percent of hips in the treatment group and 91% hips in the comparison group had satisfactory development, using a valid scale (Mann\u2013Whitney <jats:italic>U<\/jats:italic> test=867.50, z=\u22121.59, <jats:italic>p<\/jats:italic>=0.11). Forty children had preventive surgery (21 treatment group, 19 comparison group) and 18 children had reconstructive surgery (10 treatment, 8 comparison).<\/jats:p><jats:p><jats:bold>Interpretation\u2002<\/jats:bold> In children with bilateral spastic CP, early treatment with BoNT\u2010A and hip abduction bracing does not reduce the need for surgery or improve hip development at skeletal maturity.<\/jats:p>","DOI":"10.1111\/j.1469-8749.2012.04340.x","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T10:19:51Z","timestamp":1339496391000},"page":"743-747","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["The impact of botulinum toxin A and abduction bracing on long\u2010term hip development in children with cerebral palsy"],"prefix":"10.1111","volume":"54","author":[{"given":"KATE","family":"WILLOUGHBY","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SOON GHEE","family":"ANG","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PAM","family":"THOMASON","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H KERR","family":"GRAHAM","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,6,12]]},"reference":[{"key":"e_1_2_7_2_2","volume-title":"Cerebral Palsies: Epidemiology and Causal Pathways","author":"Stanley F","year":"2000"},{"key":"e_1_2_7_3_2","first-page":"105","volume-title":"Management of the Motor Disorders of Children with Cerebral Palsy","author":"Graham HK","year":"2004"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.00071"},{"key":"e_1_2_7_5_2","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/S0030-5898(20)31498-X","article-title":"The hip in cerebral palsy","volume":"11","author":"Bleck EE","year":"1980","journal-title":"Orthop Clin North Am"},{"key":"e_1_2_7_6_2","volume-title":"Orthopaedic Management in Cerebral Palsy","author":"Bleck EE","year":"1987"},{"key":"e_1_2_7_7_2","first-page":"477","volume-title":"Complications in Pediatric Orthopaedic Surgery","author":"Miller F","year":"1995"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2001.tb00241.x"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-8-101"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2009.01534.x"},{"key":"e_1_2_7_11_2","doi-asserted-by":"crossref","unstructured":"WynterM GibsonN KentishM et\u00a0al.Consensus statement on hip surveillance for children with cerebral palsy: Australian standards of care. 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