Mathematical modeling of indications for pelvic and proximal femurosteotomy in patients with cerebral palsy based upon clinical and radiographic parameters of the hip joint

Abstract

Relevance. A differentiated approach to pelvic and proximal femur osteotomy in hip disease among patients with cerebral palsy is a relevant subject of study. The aim of the study. Diagnostic improvement in diseases of the hip joints in cerebral palsy to create a differentiated approach to the reconstruction of the pelvis and proximal femur osteotomy based upon mathematical modeling. Materials and methods. The total number of patients was 33 patients (60 joints). We conducted a clinical and radiographic examination of the hip joints using our own method and standard anterior-posterior radiographs, determining the parameters of the hip joint. Mathematical modeling of indications for proximal femur osteotomy and combination of pelvic and proximal femur osteotomy using logistic regression was also performed. A mathematical model entitled "Probability of indications for pelvic and proximal femur osteotomy " based upon acetabular angle (AA), Reimers' index (RI), GMFCS level and ambulation for both positionings was developed. We have offered a mathematical model for determining indications for pelvic and hip osteotomy in hip joint diseases among children with cerebral palsy for a standard anterior-posterior radiograph based upon AA, RI, GMFCS level and ambulation with a model accuracy 91.1%. The critical level of indicators in which indications for pelvic and proximal femur osteotomy are detected is for AA > 23.55 ̊, for RI > 34%.