title: Salvage procedures for the painful chronically dislocated hip in cerebral palsy.
abstract: The aims of this study were to report functional outcomes of salvage procedures for patients with cerebral palsy (CP) who have chronic dislocation of the hip using validated scoring systems, and to compare the results of three surgical techniques. We reviewed 37 patients retrospectively. The mean age at the time of surgery was 12.2 years (8 to 22) and the mean follow-up was 56 months (24 to 114). Patients were divided into three groups: 14 who underwent proximal femoral resection arthroplasty (PFRA group 1), ten who underwent subtrochanteric valgus osteotomy (SVO group 2), and 13 who underwent subtrochanteric valgus osteotomy with resection of the femoral head (SVO with FHR group 3). All patients were evaluated using the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) and the Pediatric Quality of Life Inventory (PedsQL). Significant improvements occurred in most CPCHILD and PedsQL subsection scores following surgery in all patients, without significant differences between the groups. There were 12 post-operative complications. Less severe complications were seen in group 1 than in groups 2 and 3. Salvage surgery appears to provide pain relief in patients with CP who have painful chronic dislocation of the hip. The three salvage procedures produced similar results, however, we recommend the use of PFRA as the complications are less severe.
  
  
  CONCLUSIONS
  Salvage surgery can be of benefit to patients with CP with chronic painful hip dislocation, but should be limited to selected patients considering complications.
authors.affiliation: Severance Children's Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Hwang
authors.affiliation: Synod Hospital, Durtlang, Aizawl 796 025 Mizoram, India.
authors.forename: L
authors.initials: L
authors.lastname: Varte
authors.affiliation: Severance Children's Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: H W
authors.initials: HW
authors.lastname: Kim
authors.affiliation: Severance Children's Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: D H
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Gangnam Severance Hospital Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Korea.
authors.forename: H
authors.initials: H
authors.lastname: Park
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002908:Chronic Disease; D005260:Female; D006617:Hip Dislocation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D059352:Musculoskeletal Pain / Q000209:etiology / Q000601:surgery*; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: cerebral palsy; femoral head resection; hip dislocation; proximal femoral resection arthroplasty; subtrochanteric valgus osteotomy