Femoral varus derotational osteotomy without pelvic osteotomy in nonambulatory children with cerebral palsy: Minimum 5 years follow-up

• Published in: Medicine (Baltimore) 2022-01, Vol.101 (3), p.e28604-e28604
• Main Authors: Iwase, Dai, Fukushima, Kensuke, Kusumoto, Yasuaki, Metoki, Yukie, Aikawa, Jun, Kenmoku, Tomonori, Minato, Sayoko, Matsuo, Atsushi, Takaso, Masashi
• Format: Article
• Language: English
• Subjects: Cerebral Palsy - complications; Child; Female; Follow-Up Studies; Hip Dislocation - diagnostic imaging; Hip Dislocation - surgery; Humans; Joint Dislocations; Male; Observational Study; Osteotomy - methods; Retrospective Studies; Treatment Outcome
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000028604

Whether femoral varus derotational osteotomy (VDRO) alone or a combination of femoral and pelvic osteotomies should be performed for hip dislocation in nonambulatory children with cerebral palsy (CP) remains controversial. Few studies have reported radiographical results after the surgical treatment in nonambulatory children with CP. This study aimed to assess the results and determine predictors indicating progressive hip subluxation and redislocation after VDRO without pelvic osteotomy. We retrospectively analyzed 22 hips in 15 nonambulatory children with CP. All patients underwent VDRO without pelvic osteotomy and were followed up for at least 5 years. The mean follow-up period was 7.3 ± 1.9 years. In radiological assessments, we investigated migration percentage (MP), center-edge angle, neck-shaft angle, teardrop distance, break in Shenton's line (SL), sharp's angle, acetabular ridge angle (ARA), and the change ratio of MP (Change MP). We classified patients with an MP of