title: Short-term effects of proximal femoral derotation osteotomy on kinematics in ambulatory patients with spastic diplegia.
abstract: The aim of this retrospective study was to determine the short-term effects of proximal femoral derotation osteotomy (FDO) on gait in 53 ambulatory patients with spastic diplegia controlling all confounding procedures. All patients showed a jump gait pattern and had undergone bilateral rectus femoris transfer, distal hamstring lengthening, and tendo-Achilles lengthening as a single-event multilevel surgery. Of these, additional bilateral proximal FDOs were included in 25 patients, defined as the FDO group; the other 28 patients were defined as the no-FDO group. Kinematic variables, such as pelvic tilt, minimal hip flexion in stance, hip rotation, and foot progression angle, were compared between the two groups at postoperative 1 year. Hip extension, hip rotation, and hip adduction improved significantly after surgery in the FDO group (P<0.001, P=0.004, P=0.028), but not in the no-FDO group. Foot progression angle improved in both groups, but the degree of improvement was significantly greater in the FDO group (P=0.004). In conclusion, FDO improved hip rotation, hip adduction, and hip extension as well as foot progression angle in the ambulatory patients with spastic diplegia showing a jump gait.
authors.affiliation: Department of Orthopaedic Surgery, Inha University Hospital, Incheon, Korea.
authors.forename: Dae Gyu
authors.initials: DG
authors.lastname: Kwon
authors.forename: Seung Yeol
authors.initials: SY
authors.lastname: Lee
authors.forename: Tae Won
authors.initials: TW
authors.lastname: Kim
authors.forename: Chin Youb
authors.initials: CY
authors.lastname: Chung
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Lee
authors.forename: Ki Hyuk
authors.initials: KH
authors.lastname: Sung
authors.forename: Bekhzad
authors.initials: B
authors.lastname: Akhmedov
authors.forename: In Ho
authors.initials: IH
authors.lastname: Choi
authors.forename: Tae-Joon
authors.initials: TJ
authors.lastname: Cho
authors.forename: Won Joon
authors.initials: WJ
authors.lastname: Yoo
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Park
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome