Abstract

Purpose To analyse the outcome of twenty children (24 hips), C.P. patients with established dislocation of the hips submitted to surgical reduction.

Methodology Betwen 1998 to 2002, a retrospective review of twenty children, (24 hips) with spastic or mixed quadriplegic cerebral palsy with established hip dislocation was undertaken,. Patients were operated by the same technique: – open reduction and capsulorraphy (anterior approach) plus proximal femoral VDRO with shortening of the femur and psoas tenotomy (lateral approach). Follow-up was 4.6 years (2–6 y). Age average 9.4 years, (range 4y 8m to 13y 6m). There were 12 boys and 8 girls. All patients were mentally retarded and nonambulatory. All patients were clinically evaluated, pre and postoperatively, and pelvic AP X-rays were taken in a standard supine position, in order to determine the percentage of uncover-age of the femoral head (Reimer’s method) and the acetabular index.

Results The results were generally good with a postop migration percentage of 21,1% (1 hip subluxated) and a better acetabular index. As complications we had 1 fracture, 3 pressure sores and 1 epiphysiodesis. As clinical evaluation we had difficulty in wheelchair seating in 4 patients and pain in 2 patients.

Conclusion Concentric stable reduction of the dislocated femoral head is quite possible with an agressive surgical technique. An easy reposition of the femoral head without any abnormal tension is possible through a generous shortening of the femur, usually without need of an extra bone procedure in the acetabulum. As these patients are always bone immature is possible to extend this surgical procedure into the adolescents.

Footnotes

  • Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.