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Short-term results of musculotendinous release for paralytic hip subluxation in children with spastic cerebral palsy



Short-term results of musculotendinous release for paralytic hip subluxation in children with spastic cerebral palsy



Annals of the Royal College of Surgeons of England 90(2): 127-132



Children with paralytic hip subluxation secondary to spastic cerebral palsy were treated with a standard protocol that depended on early detection of the subluxation using clinical examination detecting limited range of hip abduction of or= 33% migration as indications. Patients underwent open adductor longus, proximal gracilis and proximal rectus femoris myotomy, and iliopsoas lengthening with immediate postoperative immobilisation in abduction bar for 3 weeks followed by physiotherapy. The protocol was applied to 50 children with a mean age of 3.6 years with 100 hips surgically corrected. Of these hips initially, 52% were mildly subluxated with 33-66% migration, and 6% were severely subluxated with > 66% migration. At a final postoperative follow-up of at least 24 months, 22% of these hips were classified as excellent with full containment and no migration, 54% were good with < 20% migration, and 24% were fair with 20-25% migration. No poor result with > 25% migration was obtained. No child developed an abduction contracture or wide-based gait that required treatment. Early detection and application of this treatment algorithm for children with spastic hip disease should have satisfactory outcomes. Longer follow-up will be required to determine how many children will need bony reconstruction to maintain stable containment of hips at maturity.

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Accession: 055761609

Download citation: RISBibTeXText

PMID: 18325212

DOI: 10.1308/003588408x261555


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