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Proximal femoral diaphysectomy in cerebral palsy.

Abstract

A study was conducted to evaluate the outcome of massive proximal femoral shortening in the cerebral palsy patient with severe spastic quadriplegia and hip instability. A retrospective review of 13 children (age range: three to 19 years of age) representing 18 hips treated with massive shortening of the proximal femur was conducted. Bilateral procedures were performed in five patients. All procedures were performed between February 1986 and March 1990. Radiographs were evaluated for preoperative and postoperative migration percentage (MP) and femoral neck-shaft angle (NSA). Charts were reviewed for complications and clinical results. All femoral osteotomies healed without difficulty. Clinical follow-up averaged 27.6 months. Satisfactory results occurred in all but one hip. Radiographs taken an average of 19.5 months postoperatively showed improved MP in all but one hip. The average preoperative MP was 70% and postoperative MP was 18%. Femoral NSA also was improved. Heterotopic bone formed in 13 hips but caused no significant problems. Other complications included postoperative seizure, urinary tract infection, cast sores, transient arm weakness, weight loss, pin protrusion through skin, and femur fracture after cast removal. Based on the good results and minimal complications in this series, massive femoral shortening appears to be a superior alternative to proximal femoral resection in these difficult patients.

Authors+Show Affiliations

,

Carolina Orthopaedic Associates, Aiken, South Carolina.

Source

Contemporary orthopaedics 29:1 1994 Jul pg 52-8

MeSH

Adolescent
Adult
Cerebral Palsy
Child
Child, Preschool
Female
Femur
Hip Dislocation
Humans
Joint Instability
Male
Osteotomy
Postoperative Complications
Quadriplegia
Treatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10147374

Citation

McCartney, D K., and K F. Frankovitch. "Proximal Femoral Diaphysectomy in Cerebral Palsy." Contemporary Orthopaedics, vol. 29, no. 1, 1994, pp. 52-8.
McCartney DK, Frankovitch KF. Proximal femoral diaphysectomy in cerebral palsy. Contemp Orthop. 1994;29(1):52-8.
McCartney, D. K., & Frankovitch, K. F. (1994). Proximal femoral diaphysectomy in cerebral palsy. Contemporary Orthopaedics, 29(1), pp. 52-8.
McCartney DK, Frankovitch KF. Proximal Femoral Diaphysectomy in Cerebral Palsy. Contemp Orthop. 1994;29(1):52-8. PubMed PMID: 10147374.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Proximal femoral diaphysectomy in cerebral palsy. AU - McCartney,D K, AU - Frankovitch,K F, PY - 1994/6/7/pubmed PY - 1994/6/7/medline PY - 1994/6/7/entrez SP - 52 EP - 8 JF - Contemporary orthopaedics JO - Contemp Orthop VL - 29 IS - 1 N2 - A study was conducted to evaluate the outcome of massive proximal femoral shortening in the cerebral palsy patient with severe spastic quadriplegia and hip instability. A retrospective review of 13 children (age range: three to 19 years of age) representing 18 hips treated with massive shortening of the proximal femur was conducted. Bilateral procedures were performed in five patients. All procedures were performed between February 1986 and March 1990. Radiographs were evaluated for preoperative and postoperative migration percentage (MP) and femoral neck-shaft angle (NSA). Charts were reviewed for complications and clinical results. All femoral osteotomies healed without difficulty. Clinical follow-up averaged 27.6 months. Satisfactory results occurred in all but one hip. Radiographs taken an average of 19.5 months postoperatively showed improved MP in all but one hip. The average preoperative MP was 70% and postoperative MP was 18%. Femoral NSA also was improved. Heterotopic bone formed in 13 hips but caused no significant problems. Other complications included postoperative seizure, urinary tract infection, cast sores, transient arm weakness, weight loss, pin protrusion through skin, and femur fracture after cast removal. Based on the good results and minimal complications in this series, massive femoral shortening appears to be a superior alternative to proximal femoral resection in these difficult patients. SN - 0194-8458 UR - https://www.unboundmedicine.com/medline/citation/10147374/Proximal_femoral_diaphysectomy_in_cerebral_palsy L2 - http://www.diseaseinfosearch.org/result/1228 DB - PRIME DP - Unbound Medicine ER -