Τίτλος:
Derotational Subtrochanteric Osteotomy and External Fixation for the
Treatment of Neurogenic Hip Dislocation in Children with Cerebral Palsy:
Could This Be a Viable Method of Treatment?
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose
The treatment of painful and chronic dislocated hip in children with
severe cerebral palsy (CP) is particularly demanding and controversial.
Numerous surgical techniques have been described, and their outcomes
vary a lot. The purpose of the present study is to evaluate a new
method, which combines varus derotational subtrochanteric osteotomy
(VDSO) and external osteosynthesis: (VDSOEO).
Methods
Six non-ambulatory children with spastic quadriplegia and chronic
dislocated painful hips were treated. The technique involved a small
incision on the subtrochanteric site of the osteotomy, followed by
retention with a single-sided external osteosynthesis with rotational
correction capability [swiveling clamp (SC)] for the reduction of the
femur head in the acetabulum, and finally by the osteotomy. Hardware was
removed without a second intervention four-six months postoperatively
and after the osteotomy was healed. Evaluation of the method was based
on clinical, functional, and radiological criteria.
Results
Four patients achieved improved radiological scores. Two patients
demonstrated resubluxation during the period of the osteotomy’s healing
process. However, no patients experienced pain, and all were able to sit
post-surgery, while caregivers reported improved capacity for nursing
care.
Conclusions
It is our strong belief that this approach can improve the quality of
life in children with severe CP and painful and chronic dislocated hips.
It is a viable and definitely less invasive procedure than classic
pelvic or femur osteotomies.
Συγγραφείς:
Angelis, Stavros
Vynichakis, Georgios
Trellopoulos, Angelos and
Apostolopoulos, Alexandros
Filippou, Dimitrios
Salmas, Marios
and Chandrinos, Michail
Balfousias, Theodore
Palaiodimos,
Leonidas
Kyriazi, Niki
Michelarakis, John
Λέξεις-κλειδιά:
cerebral palsy; subtrochanteric osteotomy; external osteosynthesis;
swivelling clamp; dislocated hips; reimers's migration index; tonnis
classification system; gross motor function classification scale;
shenton's line
