Recurrent internal hip rotation gait in cerebral palsy: Case reports of two patients.

HRB Open Res

Gait Analysis Laboratory, Central Remedial Clinic, Dublin, Dublin, Dublin 3, Ireland.

Published: January 2019

AI Article Synopsis

  • * Two patients with bilateral cerebral palsy are reported to have recurrent unilateral internal hip rotation despite surgery, and both show common risk factors for this recurrence.
  • * The study compares pre and post-surgery gait patterns, revealing that both patients reverted to a similar amount of internal hip rotation that maximizes hip function, indicating that surgery alone may not be sufficient to prevent recurrence.

Article Abstract

Internal hip rotation in cerebral palsy (CP) is typically treated with a femoral derotation osteotomy. This has been shown to be largely a successful procedure but recurrence rates up to 41% have been reported. Reported risk factors include younger age, reduced hip joint impulse and ankle plantar-flexion.  We report on two patients with bilateral CP demonstrating recurrent unilateral internal hip rotation despite surgical intervention(s).  Both demonstrate a number of the reported risk factors for recurrence.  In addition, this case report specifically compared gait kinematic patterns pre and post recurrence. On comparing both patient's hip rotation and ankle dorsi/plantarflexion kinematics they are seen to be almost identical both pre-operatively and post-operatively. Both patients appear to revert to approximately 30 of internal hip rotation which has been shown to maximise hip abductor function. Therefore, this case report suggests that surgical derotation in isolation is unlikely to be successful in this group and we suggest that this hip and ankle pattern may help predict recurrence in unilateral internal hip rotation.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308961PMC
http://dx.doi.org/10.12688/hrbopenres.12893.2DOI Listing

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