Long-term outcome of reconstruction of the hip in young children with cerebral palsy

• Published in: The bone & joint journal Vol. 95-B; no. 2; p. 259
• Main Authors: Dhawale, A A, Karatas, A F, Holmes, L, Rogers, K J, Dabney, K W, Miller, F
• Format: Journal Article
• Language: English
• Published: England 01-02-2013
• Subjects: Cerebral Palsy - complications; Cerebral Palsy - surgery; Child; Child, Preschool; Female; Hip Dislocation - complications; Hip Dislocation - surgery; Hip Joint - surgery; Humans; Infant; Male; Orthopedic Procedures - adverse effects; Orthopedic Procedures - methods; Osteotomy - adverse effects; Osteotomy - methods; Reoperation; Treatment Outcome
• ISSN: 2049-4408
• DOI: 10.1302/0301-620X.95B2.30374

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.