Related Experiment Video
Updated: Aug 14, 2026
Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
Recurrence after femoral derotational osteotomy in cerebral palsy
Hayong Kim1, Michael Aiona, Michael Sussman
1Eulji University School of Medicine, Tunsan-dong, Daejeon City, Korea. hayong_kim@yahoo.com
Insights
Femoral derotational osteotomy (FDO) corrects medial femoral torsion in children with cerebral palsy. However, long-term follow-up shows correction may deteriorate, especially in younger patients.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Cerebral palsy research
Background:
- Medial femoral torsion is common in children with cerebral palsy, affecting gait and hip mechanics.
- Femoral derotational osteotomy (FDO) is a surgical option to address this condition.
Purpose of the Study:
- To evaluate the long-term efficacy of distal femoral derotational osteotomy (FDO) for medial femoral torsion in ambulatory children with cerebral palsy.
- To assess the durability of surgical correction and identify factors influencing outcomes.
Main Methods:
- A retrospective study of 30 ambulatory children (45 femurs) who underwent distal FDO for medial femoral torsion.
- Long-term follow-up (mean 6.5 years) including clinical assessment of hip rotation and kinematic analysis.
Main Results:
- Initial surgical correction was achieved, but 15 out of 45 femurs showed recurrence of deformity during follow-up.
- Passive and kinematic hip external rotation demonstrated progressive deterioration of correction over time.
- Patients undergoing surgery before age 10 were significantly more likely to experience deterioration of correction.
Conclusions:
- Distal FDO provides initial correction for medial femoral torsion in cerebral palsy, but long-term results indicate a risk of recurrence and deterioration.
- Age at surgery is a critical factor, with younger children being more susceptible to loss of correction.
- Further research is needed to optimize surgical timing and techniques for sustained correction.
Abstract:
The authors studied the long-term results of femoral derotational osteotomy (FDO) for medial femoral torsion in ambulatory children with cerebral palsy. Thirty children with 45 femurs that underwent distal FDO were followed for a mean of 6.5 years. Although correction was achieved after surgery, recurrence occurred during follow-up in 15 femurs. Preoperative mean external hip rotation of 10.7 +/- 7.2 degrees increased to 41.3 +/- 16.6 degrees 1 year after surgery and decreased to 28.2 +/- 14.7 degrees 5 years after surgery. On kinematic data, maximum hip rotation in stance of 30 degrees before surgery decreased to 8.7 degrees 1 year after surgery and increased to 16.1 degrees 5 years after surgery. Minimum hip rotation of 10.4 degrees before surgery was corrected to -4.3 degrees 1 year after surgery and was 0.8 degrees 5 years after surgery. Passive hip external rotation and kinematic hip rotation showed progressive deterioration of the initial correction. Patients having surgery prior to age 10 were more likely to show deterioration.