title: TREATMENT OF PARALYTIC HIP DISLOCATION AMONG SPASTIC QUADRIPLEGIC CEREBRAL PALSY PATIENTS BY MEANS OF FEMORAL AND PELVIC OSTEOTOMY, WITHOUT OPENING THE JOINT CAPSULE (CAPSULOPLASTY).
abstract: OBJECTIVE
  To show the preoperative planning and results from surgical treatment for paralytic hip dislocation among patients with cerebral palsy. The techniques used were proximal femoral varus derotation osteotomy in association with Dega iliac osteotomy, without opening the joint capsule.
  
  
  METHODS
  We performed a retrospective review of ten hips in eight patients with spastic quadriplegic cerebral palsy who underwent surgical treatment between 2003 and 2005, with the same surgical technique. The pre and postoperative clinical and radiological parameters, and the preoperative planning using an image intensifier, were assessed. The clinical parameters analyzed were: pain, hygiene-related difficulties and positioning difficulties. The radiological parameters were Reimer's index, the acetabular index and the neck-shaft angle. These results were subjected to statistical analysis.
  
  
  RESULTS
  We obtained good results with this technique. After a mean follow-up of three years, all the hips were observed to be stable at the last assessment, and there was a high degree of satisfaction among the families in relation to the treatment. We also showed that preoperative planning using an image intensifier allowed us to reduce and stabilize these hips without the need for capsuloplasty.
  
  
  CONCLUSIONS
  The authors conclude that in treating hip dislocation among spastic quadriplegic cerebral palsy patients, capsuloplasty is unnecessary for stabilizing the coxofemoral joint.
authors.affiliation: Orthopedic Pediatrician at the Disabled Children's Care Association of Sao Paulo (AACD-SP).
authors.forename: Fernando Farcetta
authors.initials: FF
authors.lastname: Junior
authors.affiliation: Orthopedic Pediatrician at the Disabled Children's Care Association of Sao Paulo (AACD-SP).
authors.forename: Fabio Peluzo
authors.initials: FP
authors.lastname: Abreu
authors.affiliation: Orthopedic Pediatrician at the Disabled Children's Care Association of Sao Paulo (AACD-SP).
authors.forename: Daniella Lins
authors.initials: DL
authors.lastname: Neves
authors.affiliation: Orthopedic Pediatrician at the Disabled Children's Care Association of Sao Paulo (AACD-SP).
authors.forename: Paulo Facciola
authors.initials: PF
authors.lastname: Kertzman
authors.affiliation: Orthopedic Pediatrician at the Disabled Children's Care Association of Sao Paulo (AACD-SP).
authors.forename: Alexandre
authors.initials: A
authors.lastname: Zuccon
authors.affiliation: Orthopedic Pediatrician at the Disabled Children's Care Association of Sao Paulo (AACD-SP).
authors.forename: Simone
authors.initials: S
authors.lastname: De Oliveira Bittencourt
authors.affiliation: Resident Physician at the Disabled Children's Care Association of Sao Paulo (AACD-SP).
authors.forename: Davi Moshe Leopold
authors.initials: DM
authors.lastname: Lopes
keywords: Cerebral palsy; Femur; Hip dislocation; Osteotomy