title: The McHale procedure in the treatment of the painful chronically dislocated hip in adolescents and adults with cerebral palsy.
abstract: We retrospectively studied the results achieved in adolescent and adult patients with cerebral palsy, following management of chronically painful dislocated hips with the McHale procedure. Thirteen patients with seventeen procedures were included in the study. The indication for surgery was pain in all patients. Limitation in sitting was also reported in eight cases and nursing care was difficult in ten of thirteen patients. All patients underwent clinical and radiological examination of the hips, and a questionnaire was answered by both parents and caretakers. Improvement was noted in all patients with respect to pain. In six patients sitting was tolerated for longer intervals and 10 out of 13 patients were easier to nurse owing to improved mobility of the hip. Although these results appear promising, the procedure had a high complication rate, including heterotopic ossification, residual pain caused by hardware, fracture and pulmonary complications, for which a second procedure was necessary in several cases. There was also in several cases a prolonged period of pain postoperatively, for which an additional procedure was needed in eight patients. The McHale procedure is a technique that can provide pain relief and improvement in motion. There is however a high incidence of failure and complications.
authors.affiliation: Department of Children's Orthopaedics, University Hospital Pellenberg, Leuven, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Van Riet
authors.forename: Pierre
authors.initials: P
authors.lastname: Moens
mesh_terms: D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000150:complications*; D002908:Chronic Disease; D005260:Female; D006617:Hip Dislocation / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000453:epidemiology / Q000601:surgery; D019637:Orthopedic Procedures; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D055815:Young Adult