Long-term outcome of reconstruction of the hip in young children with cerebral palsy.
We reviewed the long-term radiological outcome, complications and revision operations in 19 children with quadriplegic cerebral palsy and hip dysplasia who underwent combined peri-iliac osteotomy and femoral varus derotation osteotomy. They had a mean age of 7.5 years (1.6 to 10.9) and comprised 22 hip dislocations and subluxations. We also studied the outcome for the contralateral hip. At a mean follow-up of 11.7 years (10 to 15.1) the Melbourne cerebral palsy (CP) hip classification was grade 2 in 16 hips, grade 3 in five, and grade 5 in one. There were five complications seen in four hips (21%, four patients), including one dislocation, one subluxation, one coxa vara with adduction deformity, one subtrochanteric fracture and one infection. A recurrent soft-tissue contracture occurred in five hips and ten required revision surgery. In pre-adolescent children with quadriplegic cerebral palsy good long-term outcomes can be achieved after reconstruction of the hip; regular follow-up is required.
Nemours/Alfred I duPont Hospital for Children, Department of Orthopaedics, Wilmington, Delaware 19803, USA.
A A
AA
Dhawale
A F
AF
Karatas
L
L
Holmes
K J
KJ
Rogers
K W
KW
Dabney
F
F
Miller
D002547:Cerebral Palsy / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006617:Hip Dislocation / Q000150:complications / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D016896:Treatment Outcome