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Surgical prevention of hip luxation in cerebral palsied children
Przemysław Potasz1, Janusz M Dobrowolski
1Specjalistyczny Szpital Kompleksowej Rehabilitacji i Ortopedii Dzieciecej "Górka"
Insights
Tenotomy of thigh adductor and psoas muscles improved hip stability in children with cerebral palsy. This surgery reduced hip migration percentage, preventing further dislocation in most cases.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Cerebral palsy research
Background:
- Cerebral palsy (CP) often leads to hip dysplasia.
- Hip instability and dislocation are common complications in severe CP.
- Surgical intervention is crucial for managing hip dysplasia in CP patients.
Purpose of the Study:
- To evaluate the effectiveness of tenotomy for adductor and iliopsoas muscles in treating hip dysplasia in children with cerebral palsy.
- To assess changes in hip stability and migration percentage post-surgery.
- To determine the risk of hip luxation following the procedure.
Main Methods:
- A study involving 40 dysplastic hips in 20 severely tetraplegic cerebral palsied children (ages 4-8).
- Radiological evaluation using anteroposterior X-rays to measure Reimers migration percentage.
- Prophylactic tenotomies of adductor and psoas muscles performed on all patients.
- A 1-year follow-up period for assessing treatment outcomes.
Main Results:
- Improved hip stability and decreased migration percentage observed in 18 patients (36 hips).
- No significant changes in migration percentage noted in 2 patients (4 hips).
- No deterioration of hip joint function was observed in any of the treated hips.
Conclusions:
- Tenotomy of thigh adductor and greater iliopsoas muscles is an effective treatment for hip dysplasia in severely tetraplegic cerebral palsy.
- The procedure demonstrates potential in improving hip stability and reducing the risk of dislocation.
- Further research may explore long-term outcomes and applicability across different CP severities.
Abstract:
Background. The purpose of this article is to present treatment outcomes for dysplastic hips in cerebral palsy, operated by tenotomy of the thigh adductor muscles and the greater iliopsoas muscle. Material and methods. 40 dysplastic hips in 20 severely tetraplegic cerebral palsied children were evaluated. The study group included children from 4 to 8 years. All patients were examined radiologically, with X-rays taken in anterio-posterior position and measurements were taken to record migration percentage according to Reimers. On that basic the hips were evaluated and the risk of possible paralytic hip luxation was predicted. In all the assessed patients prophylactic tenotomies of adductors and psoas muscles were made. The follow-up period was 1 year. Results. In 18 patients we observed better hip stability and decreased migration percentage in the evaluated hips. In two patients (four hips) we observed no changes of migration percentage. No deterioration of hip functions was observed in there joints.