Functional gait outcomes following derotation osteotomy for transverse plane malalignment in unilateral cerebral...

Transverse plane malalignment is a deformity often encountered in patients with Cerebral Palsy (CP) and derotational osteotomy (DO) represents the gold standard for correction of this condition. Reports specifically on unilaterally involved individuals are limited and it remains unclear whether DO is capable to additionally improve hip abductor lever arm dysfunction. 20 individuals with unilateral CP matched the inclusion criteria. Pre- and postoperative (short-term after unilateral DO) 3D-instrumented gait analyses (IGA) were compared and assessed for changes in transverse plane kinematics. Pelvic/trunk kinematics as well as coronal hip kinetics were included. Most remarkable findings were an improved/reduced, yet not physiological, pelvic retraction, significantly improved internal rotation of the hip and significantly improved foot progression. Trunk obliquity worsened postoperatively in the GMFCS level I subgroup. DO effectively improves internal hip rotation and foot progression. There were no relevant changes evident concerning trunk lean, indicating that DO does not relevantly improve hip abductor lever arm dysfunction in unilateral CP at short-term.