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Incomplete transiliac osteotomy in skeletally mature adolescents with cerebral palsy.
- Source :
-
Clinical orthopaedics and related research [Clin Orthop Relat Res] 2007 Sep; Vol. 462, pp. 169-74. - Publication Year :
- 2007
-
Abstract
- Incomplete transiliac osteotomy is commonly used in the surgical treatment of spastic hip disease in children with cerebral palsy. The osteotomy hinges through an intact sciatic notch and an open triradiate cartilage. We asked whether incomplete transiliac osteotomy, combined with varus osteotomy of the femur and soft tissue reconstruction, performed after skeletal maturity could improve hip coverage and acetabular shape and provide pain relief in patients with spastic hip disease. We retrospectively evaluated 27 consecutive adolescent patients (33 hips) with cerebral palsy in whom an incomplete transiliac osteotomy was performed after closure of the triradiate cartilage. The mean age at surgery was 15 years. Five hips were dislocated and 28 hips were subluxated preoperatively. The minimum followup was 2 years (mean, 3.3 years; range, 2 years-7.5 years). The subluxated hips had a minimum Reimers' migration index of 23% (mean, 52%; range, 23-95%), which was reduced to 0% (mean, 7%; range, 0-39%) at followup. The minimum preoperative Sharp's angle was 34 degrees (mean, 52 degrees ; range, 34 degrees -70 degrees ), which was reduced to 20 degrees (mean, 35 degrees ; range, 20 degrees -50 degrees ) at followup. A painless hip was achieved in 26 of 33 hips at followup. An incomplete transiliac osteotomy can be performed after skeletal maturity, resulting in a painless and stable hip in the majority of patients.
- Subjects :
- Adolescent
Adult
Cerebral Palsy complications
Cerebral Palsy physiopathology
Female
Femur growth & development
Femur surgery
Hip Dislocation etiology
Hip Dislocation surgery
Humans
Male
Muscle Spasticity etiology
Muscle Spasticity physiopathology
Muscle Spasticity surgery
Pain surgery
Plastic Surgery Procedures
Retrospective Studies
Treatment Outcome
Cerebral Palsy surgery
Ilium surgery
Osteotomy methods
Subjects
Details
- Language :
- English
- ISSN :
- 0009-921X
- Volume :
- 462
- Database :
- MEDLINE
- Journal :
- Clinical orthopaedics and related research
- Publication Type :
- Academic Journal
- Accession number :
- 17563700
- Full Text :
- https://doi.org/10.1097/BLO.0b013e318124fdca