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Percutaneous pelvic osteotomy and intertrochanteric varus shortening osteotomy in nonambulatory GMFCS level IV and V cerebral palsy patients: preliminary report on 30 operated hips.
MedLine Citation:
PMID:  22990440     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
This study evaluated the outcome of severe cerebral palsy patients (Gross Motor Function Classification System level IV and V) treated by simultaneous percutaneous pelvic osteotomy and intertrochanteric varus shortening osteotomy for hip subluxation or dislocation between 2002 and 2011. Twenty-four patients (30 hips) with an average age of 9.4 years (5-16.5) were reviewed at a mean follow-up of 35.9 months (6-96). Percutaneous pelvic osteotomy lasted on average 30 min/patient per side (25-40) and was always performed through a skin incision of 2-3 cm. The migration percentage and acetabular angle were assessed on plain radiographs. The mean Reimers' migration percentage improved from 67.1% (42-100) preoperatively to 7.7% (0-70) at the last follow-up and the mean acetabular angle improved from 31.8° (22-48) to 15.7° (5-27). Five patients presented complications: one redislocation, one bone graft dislodgement, and three with avascular necrosis of the femoral head. This study should be considered as a pilot study. These results indicate that this combined approach is an effective, reliable, and minimally invasive alternative method for the treatment of spastic dislocated hips in severe cerebral palsy patients with an outcome similar to standard techniques reported in the literature.
Authors:
Federico Canavese; Horacio Gomez; André Kaelin; Dimitri Ceroni; Geraldo de Coulon
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-16
Journal Detail:
Title:  Journal of pediatric orthopedics. Part B     Volume:  -     ISSN:  1473-5865     ISO Abbreviation:  J Pediatr Orthop B     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9300904     Medline TA:  J Pediatr Orthop B     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aDepartment of Pediatric Surgery, University Hospital Estaing, Clermont Ferrand, France bDepartment of Traumatology, Posadas Hospital, Buenos Aires, Argentina cDepartment of Peditiatric Orthopedics, University Hospitals of Geneva, Geneva, Switzerland.
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