[Surgical treatment of dislocations and subdislocations of the hip in patients with cerebral palsy by femoral and pelvic osteotomy].
Fifty-one skeletally immature cerebral palsied (C.P.) children with 70 subluxated or dislocated hips were treated by conservative methods: femoral osteotomy (65 hips), pelvic osteotomy (52 hips) and arthrotomy when necessary (19 cases). 31 children were less than 10 years of age when operated on (mean 6 years, 6 months), 20 children were more than 10 years of age (mean 13 years, 13 months); mean follow-up was 4 years. Reduction and coverage were achieved and maintained in all patients, except for 6 redislocations: a pelvic obliquity was neglected in 3 cases; femoral shortening was not performed in 2 cases. Post-operative course was difficult in eldest patients with pain and stiffness but functional result was acceptable at follow-up in all cases except redislocations. Open reduction was related to a higher rate of postoperative rehabilitation problems. Modeling of previously deformed femoral heads and improvement of hip mobility were consistently seen at last follow-up, except for 3 redislocations. It is concluded that conservative methods are quite advisable in CP children and adolescents. Hip reduction should be preferred to femoral resection even in adolescent.
Onimus
M
M
Service de Chirurgie des scolioses et Orthopédie infantile, Hôpital Saint-Jacques, Besançon.
Manzone
P
P
Cahuzac
J P
JP
Laurain
J M
JM
Lebarbier
P
P
D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications / Q000601:surgery*; D002648:Child; D005269:Femur / Q000601:surgery; D006617:Hip Dislocation / Q000601:surgery*; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D010384:Pelvic Bones / Q000601:surgery; D011184:Postoperative Period; D011782:Quadriplegia / Q000601:surgery
Le traitement chirurgical des luxations et subluxations de hanche chez l'IMC par ostétomie fémorale et pelvienne.