A new technique for proximal femoral resection in non-ambulatory patients with cerebral palsy

Abstract

Proximal femoral resection may be proposed to non-ambulatory patients with cerebral palsy and chronic painful hip dislocation. McCarthy's technique confers good results but does not solve the problems related to femoral reascension (bone migration causing painful osseous or cutaneous conflict). We describe a new technique of resection-interposition of the proximal end of the femur which preserves the greater trochanter by an orthogonal osteotomy below the lesser trochanter while maintaining the gluteal-vastus lateralis strut in continuity. A suture of the remaining joint capsule upon itself and a trans-trochanteric capsulodesis are associated to stabilize the cephalic displacement of the femur.

Keywords: Cerebral palsy; Non-ambulatory patient; Proximal femoral resection arthroplasty; Spastic hip dislocation.