Scissoring

In this condition the legs will cross each other in standing position. It is commonly seen in cerebral palsy. The spastic adductor muscles and gracilis cause this condition. Scissoring causes difficulty in walking. Every time the child wants to walk the legs cross each either leading to difficulty in progression in gait. Weakness in hip abductor and pelvic muscles is also seen in this condition. The child can also have dislocation of hip joint. Hence radiographs are mandatory. The current guideline is that children with cerebral palsy should have a hip radiograph every year to check for progressive subluxation and dislocation. The treatment includes surgical lengthening of muscles and physiotherapy. If the hip joint shows dislocation then the joint needs to be reduced and bony correction is also required. The treatment of hip dislocation is prolonged and difficult and hence every precaution should be taken to ensure that hip does not dislocate.

Scissoring in a 4 year old child with cerebral palsy
Radiograph of hip showing dislocation of left hip
Radiograph of hip after surgery showing well reduced hip joint