An evaluation of surgical outcomes in luxation and subluxation of the hip joint in children with cerebral palsy.

The goal of this work is to evaluate the suitability of the surgical operations used in severe forms of cerebral palsy with luxation or subluxation of the hips. The research involved 32 children with cerebral palsy and subluxation or luxation of the hip joint. 28 of these children had a severe form of quadriplega, and 4 had diplegia. In all cases, surgery was performed on the adductors, and in most cases on the bone system as well. Derotational-varizing osteotomies were performed 24 times, pelvic osteotomies using Dega's method 10 times, Salter's method seven times, Schanz's method 2 times, and triple pelvic osteotomy using Steele's method once. In three cases the femoral head was resected. The Salter and Dega osteotomies were evaluated as favorable in relation to the proper centering of the hip and securing it against renewed dislocation. On the other hand, over-correction of the increased neck-diaphysis angle caused a limitation in abduction, thus intensifying nursing difficulties. This method was evaluated particularly negatively in cases of pelvic tilt. In view of these outcomes in the surgical treatment of spastic hip luxations and subluxations, it would seem best to prevent dislocation by the appropriate rehabilitation and nursing procedures, and by early detection of dislocation.