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

Bone Joint J. 2013 Feb;95-B(2):259-65. doi: 10.1302/0301-620X.95B2.30374.

Abstract

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.

MeSH terms

  • 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