We reviewed the long-term radiological outcome, complications and revision operations in 19 children with quadriplegic cerebral palsy and hip dysplasia who underwent combined peri-iliac osteotomy and femoral varus derotation osteotomy. They had a mean age of 7.5 years (1.6 to 10.9) and comprised 22 hip dislocations and subluxations. We also studied the outcome for the contralateral hip. At a mean follow-up of 11.7 years (10 to 15.1) the Melbourne cerebral palsy (CP) hip classification was grade 2 in 16 hips, grade 3 in five, and grade 5 in one. There were five complications seen in four hips (21%, four patients), including one dislocation, one subluxation, one coxa vara with adduction deformity, one subtrochanteric fracture and one infection. A recurrent soft-tissue contracture occurred in five hips and ten required revision surgery.
In pre-adolescent children with quadriplegic cerebral palsy good long-term outcomes can be achieved after reconstruction of the hip; regular follow-up is required.
Cite this article: Bone Joint J 2013;95-B:259–65.
- Cerebral palsy
- Hip dislocation
- Pelvic osteotomy
- Femoral osteotomy
- Acetabular dysplasia
- Recurrent dislocation
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Received July 2, 2012.
- Accepted September 26, 2012.
- ©2013 The British Editorial Society of Bone & Joint Surgery