A balanced approach for stable hips in children with cerebral palsy: a combination of moderate VDRO and pelvic osteotomy
| Autor: | Kerstin Reidy, Christoph Heidt, Stefan Dierauer, Hanspeter Huber |
|---|---|
| Přispěvatelé: | University of Zurich, Reidy, Kerstin |
| Jazyk: | angličtina |
| Předmět: |
Reconstructive surgery
medicine.medical_specialty Pelvic osteotomy medicine.medical_treatment 610 Medicine & health Osteotomy VDRO Cerebral palsy 03 medical and health sciences 0302 clinical medicine 2732 Orthopedics and Sports Medicine Neck shaft angle medicine Original Clinical Article Orthopedics and Sports Medicine 10220 Clinic for Surgery 2735 Pediatrics Perinatology and Child Health Pediatrics Perinatology and Child Health Hip dysplasia 030222 orthopedics business.industry medicine.disease Surgery Hip reconstruction Pediatrics Perinatology and Child Health Orthopedic surgery business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Children's Orthopaedics |
| ISSN: | 1863-2521 |
| DOI: | 10.1007/s11832-016-0753-5 |
| Popis: | Background Hip reconstructive surgery in cerebral palsy (CP) patients necessitates either femoral varus derotational osteotomy (VDRO) or pelvic osteotomy, or both. The purpose of this study is to review the results of a moderate varisation [planned neck shaft angle (NSA) of 130°] in combination with pelvic osteotomy for a consecutive series of patients. Methods Patients with CP who had been treated at our institution for hip dysplasia, subluxation or dislocation with VDRO in combination with pelvic osteotomy between 2005 and 2010 were reviewed. Results Forty patients with a mean follow-up of 5.4 years were included. The mean age at the time of operation was 8.9 years. The majority were non-ambulant children [GMFCS I–III: n = 11 (27.5 %); GMFCS IV–V: n = 29 (72.5 %)]. In total, 57 hips were treated with both femoral and pelvic osteotomy. The mean pre-operative NSA angle of 152.3° was reduced to 132.6° post-operatively. Additional adductor tenotomy was performed in nine hips (16 %) at initial operation. Reimers’ migration percentage (MP) was improved from 63.6 % pre-operatively to 2.7 % post-operatively and showed a mean of 9.7 % at the final review. The results were good in 96.5 % ( n = 55) with centred, stable hips (MP Conclusions This approach maintains good hip abduction and reduces soft-tissue surgery. Moderate varisation in VDRO in combination with pelvic osteotomy leads to good mid-term results with stable, pain-free hips, even in patients with severe spastic quadriplegia. |
| Databáze: | OpenAIRE |
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