170.
Varus Derotation Osteotomy with the LCP-Hip plate for the
Treatment af Hip Subluxation and Dislocation in Children with Cerebral
Palsy
Nikolaj Sode, Michael Schultz-Larsen, Vilhelm Engell, Niels Wisbech
Pedersen
Department of Orthopedics Odense University Hospital, Denmark; Health
Care Unit, Danish National Defence; Department of Orthopedics, Odense
University Hospital, Denmark; Department of Orthopedics, Odense University
Hospital, Denmark
Background:
Hip dislocation and pain caused by asymmetrical muscle forces
across the hip is frequently observed in children with cerebral palsy. The
condition is complicated by an increased risk of osteoporosis. Proximal
femoral osteotomy is used in reconstructive surgery in order to improve
physical capacity. A new pediatric LCP hip plate with low lateral profile and
angular stability may improve the outcome of surgery.
Purpose / Aim of Study:
The purpose of this study was to asses results from
hip osteotomy operations using the LCP-hip plate in a group of children with
cerebral palsy hip subluxation and/or dislocation.
Materials and Methods:
A retrospective chart and radiograph review on
outcome from 48 femoral osteotomies performed on 32 children with cerebral
palsy; 22 boys and 10 girls. Unilateral femoral surgery (n=16), bilateral
femoral surgery (n=16), pelvic reconstructive surgery, (n=19) and additional
tenotomies (n=25) was performed. All children had cerebral palsy with Gross
Motor Function Classification System levels: II (n=3), III (n=2), IV (n=10), V
(
n=17).
Findings / Results:
Age at surgery 7.6 (3, 15) years (mean; min, max). Neck-
shaft angle mean correction was 30 (0, 49) degrees of varisation and mean
derotation was 23 (0, 45) degrees. Mean time to full support was 5,5 weeks (3-
12
weeks). In 29 cases shentons line was broken preoperatively,
postoperatively 15 of these were intact (data currently not available). In 2 cases
we found soft tissue irritation from the LCP hip plate. 1 case had hip
reluxation, and 1 case had spontaneus distal femur fracture. We found no cases
af deep infection, loosening of osteosynthesis material or avascular necrosis.
Conclusions:
With the LCP hip-plate we found similar results compared to
other implants. Importantly we found no case of loosening of ostesynthesis
material, suggesting the value of angular stability.
