Abstract
Background: We conducted this study to compare postoperative radiological outcomes of two surgical procedures (femoral head resection (FHR) and femoral head cap plastic surgery (FCP)) in patients with CP and hip dislocation. Methods: CP patients with Gross Motor Function Classification Score (GMFCS) IV or V, who underwent either FHR or FCP between 2007 and 2018 at Heidelberg University Hospital in Germany, were included. Most participants underwent postoperative traction in an attempt to prevent telescoping. Besides the above-mentioned objectives, we examined the association between telescoping and spasmolytic use, traction weight, and traction duration. Results: Thirty-eight CP patients were included, of whom 15 (25 hips) underwent FHR and 23 (30 hips) underwent FCP. Heterotopic ossification (grades I, II, and III) occurred in 80% and 83.3% of patients in the FHR and FCP groups, respectively. Telescoping occurred in 18.68 and 31.99% of patients in the FHR and FCP groups, respectively (p = 0.999). Other complications were similar between both groups. Conclusions: The postoperative outcomes of FHR and FCP are similar in terms of telescoping, heterotopic ossification, and complications. Although telescoping was encountered more in the FCP group, no significant difference from the FHR group was found. We noted that the weight of traction could reduce the development of telescoping.
Highlights
Cerebral palsy (CP) is characterized by a fixed lesion that affects the neurological system during development
Complete hip dislocations are commonly encountered in nonambulatory CP patients with Gross Motor Function Classification System (GMFCS) grade IV and V, and this can be quite problematic if pain is experienced or when balance, posture of hygiene becomes affected
Study Design and Eligibility Criteria. This retrospective cohort study was conducted among CP patients with hip dislocation who underwent either femoral head resection (FHR) or femoral head cap plastic surgery (FCP) during the period from 3 January 2007 to 13 December 2018 at the Heidelberg University Hospital, Department of Orthopedics and Trauma Surgery; Heidelberg, Germany
Summary
Cerebral palsy (CP) is characterized by a fixed lesion that affects the neurological system during development. The presentation of CP differs widely based on the affected area of the brain It is classified into different subtypes, the most important of which is the spastic type, which is characterized by abnormal movements in the developing musculoskeletal system [2]. Pathologic hip conditions, such as subluxation or dislocation, are of great concern in patients with CP due to a permanent spasticity in several key muscles [1]. Conclusions: The postoperative outcomes of FHR and FCP are similar in terms of telescoping, heterotopic ossification, and complications. We noted that the weight of traction could reduce the development of telescoping
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