Complications related to postoperative casting after surgical treatment of subluxed/dislocated hips in patients with cerebral palsy.
Three hundred sixteen subluxed/dislocated hips (222 patients) underwent upper femoral osteotomy. Of these, 286 (90.5%) hips were casted (average patient age: 8.9 years) and 30 (9.5%) were not (average patient age: 13.6 years). Average follow-up was 4.7 years. Complications in the casted/noncasted groups (per hip) were: 43/0 (15%/0%) skin sores; 11/1 (3.8%/3.3%) wound infections; 6/0 (2.1%/0%) instrumentation failures; 22/1 (7.7%/3.3%) reoperations; and 13/1 (4.5%/3.3%) rehospitalizations. Differences between the groups were not statistically significant. Casted patients were younger and more neurologically involved. Casting is useful to ensure healing of osteotomies, prevent instrumentation failure and injury to the operated legs, and allow for ease of handling. Complications that occurred were managed and had no long-term sequelae.
Lubicky
John P
JP
Department of Orthopedics, Shriners Hospitals for Children, 2211 N Oak Park Ave, Chicago, IL 60707, USA.
Bernotas
Sarunas
S
Herman
Jean E
JE
D000293:Adolescent; D002370:Casts, Surgical / Q000009:adverse effects*; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000209:etiology; D006617:Hip Dislocation / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy; D011182:Postoperative Care / Q000009:adverse effects; D012189:Retrospective Studies; D014946:Wound Infection / Q000209:etiology