Hip salvage surgery in cerebral palsy cases: a systematic review.

Imbalance and muscle spasticity, in association with coxa valga and persistent femoral anteversion, compromises hip development in cases of cerebral palsy and may result in chronic pain and even dislocation. Some of these hips undergo salvage surgery because of the severe impact of their abnormalities in these patients' quality of life. We conducted a systematic review of the literature to compare the results from the main hip salvage techniques applied to these individuals.

Surgical technique: Medial column arthrodesis in rigid spastic planovalgus feet.

Background: Treatment of spastic planovalgus feet is challenging, especially in patients with severe and rigid deformities. The available techniques do provide some correction but not at the site of the deformity and sometimes the correction is lost over time. We describe a new surgical approach at the site of the deformity.

Results in the treatment of paralytic calcaneus-valgus feet with the Westin technique.

Between 1988 and 2003, 23 patients with paralytic calcaneus-valgus feet were submitted to the Westin procedure and 17 patients (25 feet) were re-evaluated. Nine patients were male and eight were female. The mean age at the surgical procedure was 8+/-5 years.

Knee flexion deformity from poliomyelitis treated by supracondylar femoral extension osteotomy.

Between April 1979 and August 1993, we treated 39 patients (49 knees) with knee flexion deformity after Poliomyelitis. All were subjected to fractional hamstring lengthening and supracondylar femoral extension osteotomy in the same surgical procedure. The goal was to correct the deformity and fit the lower extremities in long braces to improve or promote gait.

Quadricepsplasty in arthrogryposis (amyoplasia): long-term follow-up.

Eight patients with arthrogryposis multiplex congenita (amyoplasia type) (11 knees) with knee hyperextension deformity underwent quadricepsplasty and were analyzed during an average follow-up period of 11 years and 2 months. The results were clinically analyzed based on gait pattern, range of movement, and orthotic requirements. Joint congruency was evaluated by radiography according to the Leveuf Pais classification.

Treatment of the painful chronically dislocated and subluxated hip in cerebral palsy with hip arthrodesis.

The purpose of this study was to evaluate 14 painful dislocated hips in patients with spastic cerebral palsy, treated with hip arthrodesis and internal fixation. The mean age at the surgical procedure was 15 years and 5 months. The mean follow-up period was 5 years and 3 months.