Proximal femoral resection and articulated hip distraction with an external fixator for the treatment of painful spastic hip dislocations in pediatric patients with spastic quadriplegia.
We describe the results obtained with an alternative method of treatment for spastic painful hip dislocations in nonambulatory patients, which consists of a proximal femoral resection with capsular interposition arthroplasty, and the addition of a hinged external fixator for postoperative articulated hip distraction to allow for an immediate upright position and the ability to sit in a wheelchair. We performed this technique in three patients (four hips) with a mean age at the time of surgery of 15 years. Postoperatively, clinical improvement was observed in all four hips, with respect to pain relief, sitting tolerance, perineal care and functional range of motion.
Department of Neuro-Orthopaedic, Institute of Orthopaedics Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Mario
M
Lampropulos
Miguel H
MH
Puigdevall
Daniel
D
Zapozko
Héctor R
HR
Malvárez
D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D003286:Contracture / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods*; D016267:External Fixators; D005260:Female; D005270:Femur Head / Q000601:surgery*; D006617:Hip Dislocation / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D010146:Pain / Q000209:etiology; D011782:Quadriplegia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014910:Wheelchairs