AI Article Synopsis
- The study analyzed 39 children with cerebral palsy who underwent surgery for hip issues, comparing two surgical approaches: varus derotation osteotomy alone and a combined procedure with acetabular surgery.
- Both groups had similar ages and preoperative hip measurements, but showed differences in the average uncoverage of the femoral head before surgery.
- Results indicated that the combined procedure led to a lower rate of hip instability and redislocation compared to the varus derotation osteotomy alone, especially in patients with greater than 70% uncoverage of the femoral head.
Article Abstract
We reviewed 39 children with cerebral palsy who had surgery for hip subluxation or dislocation. Of 55 treated hips, 31 had a varus derotation osteotomy alone, and 24 had a combination of varus derotation osteotomy and an acetabular procedure. There was no significant difference in the ages of the two groups. There was no difference in the preoperative acetabular indices of the two groups, but the average percentage of preoperative uncoverage of the femoral head was 56% in the group with varus derotation osteotomy and 63% in the group with combined varus derotation osteotomy with an acetabular procedure. The incidence of resubluxation or redislocation (24%) after varus derotation osteotomy alone was higher than that after varus derotation osteotomy with an acetabular procedure (13%). The incidence of postoperative hip instability was higher in the patients who had preoperative uncoverage of the femoral head ranging from 70 to 100%. This was in comparison with the patients who had preoperative uncoverage of the femoral head ranging from 30 to 70%. These results suggest that a combination of varus derotation osteotomy and an acetabular procedure decreases the incidence of resubluxation or redislocation, and that unstable hips with > 70% uncoverage of the femoral head should undergo the combined procedure.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Health-related quality of life after Dega pelvic osteotomy and varus derotation osteotomy due to spastic hip disease in children with cerebral palsy.
J Child Orthop
January 2025
Department of Pediatric Orthopaedics and Traumatology, Poznan University of Medical Sciences, Poznan, Poland.
Purpose: Our study aimed to present health-related quality of life (HRQL) after combined bone reconstruction in nonambulatory patients with cerebral palsy (CP) after at least a 2-year follow-up and to assess its impact on HRQL using the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire (CPCHILD) as the primary outcome measure.
Methods: In this prospective study, we analyzed 31 nonambulatory patients with spastic or mixed CP (GMFCS levels IV-V) who underwent hip reconstructive surgery between 2015 and 2021. The surgical procedures included one-sided varus derotation osteotomy of the femur with Dega transiliac osteotomy and, on the opposite side, varus derotation osteotomy (VDRO) of the femur with shortening and, as needed, Dega pelvic osteotomy.
Can a Surgical Vulnerability Score Predict Outcomes of Hip Reconstruction in Children with Severe Neuromuscular Disability?
Indian J Orthop
December 2024
Department of Paediatric Trauma and Orthopaedics, Southampton Children's Hospital, Southampton, UK.
Background: Hip surgery is often necessary for children with severe neuromuscular disabilities to avoid chronic pain resulting from hip migration. This study correlated the Surgical Vulnerability Score (SVS), a novel measure of physiological reserve, with reconstructive hip surgery outcomes to improve shared surgical decision-making.
Materials And Methods: Sixty-eight cases performed by a single surgeon were retrospectively evaluated.
The kinematic coupling during Ponseti correction in idiopathic clubfoot: A quantitative analysis.
J Clin Orthop Trauma
December 2024
Chacha Nehru Bal Chikitsalaya, New Delhi, India.
Background: The study aimed to quantify and correlate kinematic coupling linkage of foot abduction (correction of adduction) and inversion, heel varus and ankle equinus for clubfeet corrected by Ponseti technique.
Methods: Measurements of foot abduction (derotation of carpopedal block), heel varus and ankle equinus were available from Dimeglio scores in 25 feet. Radiological angles were considered for foot inversion-eversion.
Does tranexamic acid reduce blood loss for children undergoing reconstruction for neuromuscular hip dysplasia? A matched comparative study.
J Pediatr Orthop B
November 2024
Department of Biostatistics, Center for Biostatistics and Data Science, Washington University School of Medicine, St. Louis, Missouri, USA.
Treatment for neuromuscular hip dysplasia (NMHD) typically involves osteotomies of the proximal femur and/or pelvis, and the potential for significant volume blood loss is high. Tranexamic acid (TXA) functions as an antifibinolytic and has been shown to reduce bleeding in many operative settings. Retrospective evidence for the use of TXA in children undergoing NMHD reconstruction is inconclusive, and to our knowledge, prospective evaluation has never been performed.
View Article and Find Full Text PDFRisk Factors for Early Implant Failure in Geriatric Intertrochanteric Fractures Treated with Twin Interlocking Derotation and Compression Screw Cephalomedullary Nail (InterTAN).
Acta Chir Orthop Traumatol Cech
November 2024
Department of Orthopaedics and Traumatology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
Purpose Of The Study: Intertrochanteric hip fractures in elderly patients are a significant cause of morbidity and mortality, with increasing incidence due to the aging population. Despite advancements in intramedullary nailing (IMN) technology, fixation failure remains a concern. This study aims to evaluate pre-and postoperative radiographic risk factors for varus collapse in geriatric intertrochanteric fractures treated with twin interlocking derotation and compression screw cephalomedullary nail (InterTAN, Smith & Nephew).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!