[Palliative Schanz osteotomy for irreducible hip dislocation in adolescent patients with cerebral palsy].
OBJECTIVE
Palliative Schanz osteotomy is one of the options for treatment of irreducible hip dislocation in adolescent patients with cerebral palsy.


METHODS
In 1992 to 2002, Schanz osteotomy was indicated on 46 occasions in 27 nonambulatory patients with the quadriplegic form of cerebral palsy aged 9 to 18 years.


METHODS
In the postoperative evaluation, emphasis was placed on the clinical presentation, i.e., improved motion of the hip joints and pain alleviation. X-ray examination was carried out at 2 to 6 months after surgery. RESULTS In all patients, the range of motion in the hip increased in abduction or flexion according to the osteotomy technique used. Because of severe pain, one patient (2.17 %) had to undergo subsequent resection of the femoral head. Transient pain in the hip persisted in four patients (8.7%). DISCUSSION In patients older that 10 years, reconstructive surgery for neurogenic dislocations has an uncertain outcome and a palliative procedure is often the only method of choice for treatment of irreducible dislocations. Schanz angulation osteotomy can provide a better range of motion, alleviate pain and facilitate the care of patients, particularly if they are nonambulatory. CONCLUSIONS Schanz osteotomy is a less invasive method than resection of the proximal femur and should be used preferably in older children with neurogenic hip dislocation in whom reconstructive surgery is not indicated.
Schejbalová
A
A
Ortopedicka klinika 2. LF UK a FN Motol - Dĕtská a dospĕlá ortopedie a traumatologie, Praha.
D000293:Adolescent; D001863:Bone Screws; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D006617:Hip Dislocation / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D010027:Osteotomy / Q000379:methods; D010146:Pain / Q000209:etiology; D010166:Palliative Care; D016059:Range of Motion, Articular; D012086:Reoperation