title: Surgical treatment of spastic hip dislocation--to treat or not to treat?--My personal experience.
abstract: Patients with infantile cerebral palsy often develop a typical adduction-, internal rotation- and flexion contracture of the hip, caused by a central disturbance of muscle tone coordination. This deviation leads, when verticalisation and weight-bearing of the child is absent or insufficient, to coxa valga and spastic hip dislocation. In order to prevent or correct this faulty form, soft tissue release operations or bony joint reconstructive procedures of the proximal femur and acetabular roof or, in severely impaired patients, palliative measures can be performed. The indication must be judged critically, especially in patients with total body involvement. In this paper special procedures, performed for a number of years at the Orthopedic Poliklinik of the University of Munich and the Spastiker-Zentrum (Integrationszentrum für Cerebralparesen ICP) München ("Munich approach") are described, and the important role of surgery is discussed as part of a comprehensive rehabilitation program in patients with cerebral palsy, including sometimes also the decision, not to perform surgery.
authors: Orthopädische Universitäts-Poliklinik München-Innenstadt and Spastiker-Zentrum München, München, Deutschland.
authors: Sigfrid
authors: S
authors: Stotz