title: Complications associated with multiple, sequential osteotomies for children with cerebral palsy.
abstract: Children with cerebral palsy often require multiple, major reconstructive procedures. The purpose of this study was to evaluate whether multiple, major surgeries could be performed in a single setting with an acceptable complication rate. The medical records of 94 patients with a diagnosis of cerebral palsy operated on between the dates of 1993 and 1997 were reviewed. Patients were followed for a mean of 44.9+/-1.92 months. The average number of procedures per surgical session was 3.63+/-0.09 and the most common procedure performed was osteotomy of the proximal femur. The major complication rate was 24.4%. This institution's experience indicates that performance of multiple major bony procedures in one session is complicated but safe, and can be done with acceptable blood loss, infection rates and recurrence rates in a modern, multidisciplinary setting dedicated to the care of severely disabled children.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Washington, District of Columbia 20307, USA. john.tis@na.amedd.army.mil
authors.forename: John E
authors.initials: JE
authors.lastname: Tis
authors.forename: Susan
authors.initials: S
authors.lastname: Sharif
authors.forename: Brian
authors.initials: B
authors.lastname: Shannon
authors.forename: Kirk
authors.initials: K
authors.lastname: Dabney
authors.forename: Freeman
authors.initials: F
authors.lastname: Miller
mesh_terms: D016063:Blood Loss, Surgical; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index