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Updated: Aug 14, 2026

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Published on: July 2, 2021

The Evolution of Proximal Femur Hemiepiphysiodesis in Children with Cerebral Palsy

Trevor Blanchard1, James J McCarthy1, Verena M Schreiber1

  • 1Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.

Journal of Clinical Medicine
|August 13, 2026
PubMed

Insights

Proximal femoral guided growth offers a minimally invasive option for hip displacement in children with cerebral palsy (CP). This technique shows promise in improving hip alignment and may delay or reduce the need for major surgery.

Area of Science:

  • Orthopedics
  • Pediatric Musculoskeletal Disorders
  • Cerebral Palsy Research

Background:

  • Hip displacement is a progressive complication in children with cerebral palsy (CP), often linked to coxa valga and muscle imbalance.
  • Traditional treatments for advanced deformity include proximal femoral and pelvic osteotomies.

Purpose of the Study:

  • To review the current evidence on proximal femoral guided growth (PFGG) as a treatment for hip displacement in children with CP.
  • To summarize indications, surgical techniques, outcomes, complications, and future research directions for PFGG.

Main Methods:

  • Narrative review of existing literature, including retrospective case series and one systematic review.
  • Analysis of radiographic outcomes, complications, and patient factors influencing success.

Main Results:

  • PFGG demonstrates improvements in migration percentage, head-shaft angle, and acetabular index, especially when initiated early (migration <50%) and combined with soft tissue release.
  • Younger age and less severe hip displacement correlate with better outcomes.
  • The most frequent complication is implant migration, often requiring revision, but serious adverse events are rare.

Conclusions:

  • Proximal femoral guided growth is a viable intermediate treatment option for selected children with CP and hip displacement, potentially delaying or avoiding reconstructive surgery.
  • Further high-quality prospective studies are necessary to establish long-term safety, efficacy, and optimal integration into treatment algorithms.

Keywords:
cerebral palsyguided growthhip subluxationproximal femur hemiepiphysiodesis

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