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Updated: May 12, 2026
Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
Rotational osteotomy with submuscular plating in skeletally immature patients with cerebral palsy
Hyun-Joo Lee1, Chang-Wug Oh, Kwang-Soon Song
1Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu 700-721, Korea.
Background:
In cerebral palsy, intoeing gait with increased femoral anteversion is not uncommon and often requires surgical intervention. Although several conventional methods have been used, complications are common. We applied a new technique of rotational osteotomy with submuscular plating in skeletally immature patients with cerebral palsy.
Methods:
Eighteen patients (26 femora, 8 bilateral) with a mean age of 8.7 years (range, 6-16) were prospectively treated with this technique. The anatomic distribution of patients was hemiplegia (n = 7), diplegia (n = 8), and asymmetric diplegia (n = 3). Percutaneous osteotomy was performed at the middle of the femoral shaft. After rotational correction, submuscular plating was done using a locking compression plate. Femoral anteversion was evaluated by a trochanteric prominence angle test (TPAT) and computed tomography.
Results:
In all cases, each osteotomy healed in an average of 12 weeks (range, 10-14). The mean femoral anteversion by TPAT improved to 12° (range, 5°-30°) after surgery from 44° (range, 30°-65°) (p < 0.001). There were no complications of deep infection, implant failure, or limb length discrepancy over 1 cm.
Conclusions:
In skeletally immature patients with cerebral palsy, femoral anteversion can be safely corrected using submuscular plating with a locking compression plate.
