Surgery for unstable hips in cerebral palsy.
We studied 67 patients with 86 unstable hips, all of whom had total-body-involvement cerebral palsy. Sixty-four operations were performed on 53 hips in 39 patients in a sequential radiographically controlled manner. Twenty-five operations were contralateral operations on a previously treated patient or revisions of a previous procedure. Soft-tissue release alone led to recurrence of dislocation or subluxation in many patients and has been abandoned. Combined pelvic and femoral osteotomy and soft-tissue release corrected the migration percentage and center-edge angle better than femoral osteotomy and soft-tissue release alone. Excision of the proximal femur was a useful salvage procedure if the femoral head was eroded.
University Department of Orthopaedic Surgery, Royal Manchester Children's Hospital, England.
J L
JL
Barrie
C S
CS
Galasko
D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D003238:Connective Tissue / Q000601:surgery; D005260:Female; D005269:Femur / Q000601:surgery; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology / Q000601:surgery*; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D010027:Osteotomy; D010384:Pelvic Bones / Q000601:surgery; D011183:Postoperative Complications; D017211:Treatment Failure