Year: 2019
Type: conference-abstract
Abstract: Introduction and Objective Hip instability in children with cerebral palsy (CP) is a serious progressive problem. Materials and Methods 141 surgical procedures were performed on children 3 – 16 years old in 2006–2016. The purpose of surgery was eliminating the instability of hip (GMFCS 1–3) and relieving pain (GMFCS 4–5). Triple pelvic osteotomy (TPO) was performed in 5 cases on 5 patients 6 -15 years old; TPO combined with varus-detorsion femoral osteotomy (VDFO) - in 8 cases on 6 patients 7–11 years old. TPO, shortening VDFO and open head reduction were performed in 6 cases on 5 patients 7–13 years old who had hip dislocations. VDFO combined with Salter’s pelvic osteotomy were performed in 4 cases (4–6 years old). Adductor myotomy was performed in 99 cases (43 patients bilaterally), it was combined with other soft tissue releases in the lower limbs in 32 cases. Results Hip stabilization was achieved in all cases using TPO and TPO combined with VDFO Reoperation was necessary in 3 cases after VDFO. The best results after the soft tissue releases were obtained when the Reimer’s migration index was <30%, although in some cases joint stabilization was achieved after the migration index was > 80%. For this group of patients femoral osteotomy was required in 12 cases, femoral and pelvic osteotomies – in 3 cases. Conclusions Individual approach with a clear understanding goals of hip surgery and adherence to the principle ‘one-stage and multilevel correction’ are necessary in the treatment of children with CP. When the Reimer’s migration index is <30% the soft tissues release can provide hip stability, in the most severe cases combination of pelvic and femur osteotomies leads to a better result.
Source: Abstracts
Language: English
Subfield: Rehabilitation
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2980540887