Abstract
Background
The relatively new paediatric LCP hip plate (Synthes GmBH Eimattstrasse 3 CH-4436 Oberdorff) is used in children, both with and without neuromuscular disease, for fixation of proximal femoral osteotomy for a variety of indications.
Materials and methods
We retrospectively reviewed the notes and radiographs of all those children who have had paediatric LCP device for the fixation of proximal femoral osteotomy and proximal femur fractures in our institution (Royal Manchester Children’s Hospital), between October 2007 and July 2010, for their clinical progress, mobilization status, radiological healing and any complications.
Results
Forty-three paediatric LCP hip plates were used in 40 patients (27 males and 13 females) for the fixation of 40 proximal femoral osteotomies and three proximal femur fractures. This included 13 children with underlying neuromuscular pathology and 27 children without neuromuscular disease. All osteotomies and fractures radiologically healed within 6 months [majority (n = 40) within 3 months]. There was no statistically significant difference (p = 0.45) in the neck shaft angle between the immediately post-operative and final X-rays after completion of bone healing. There were no implant-related complications both in patients with and without neuromuscular disease. No metalwork loosening was observed and no plate revisions were required. Three post-operative fractures occurred in patients with neuromuscular pathology treated with post-operative plaster immobilisation.
Conclusion
The paediatric LCP hip plate provides a stable and reliable fixation of the proximal femoral osteotomy performed for a variety of paediatric orthopaedic conditions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kitakoji T, Hattori T, Iwata H (1999) Femoral varus osteotomy in Legg-Calvé-Perthes disease: points at operation to prevent residual problems. J Pediatr Orthop 19:76–81
Lloyd-Roberts GC, Catterall A, Salamon PB (1976) A controlled study of the indications for and the results of femoral osteotomy in Perthes’ disease. J Bone Joint Surg Br 58:31–36
Wenger DR, Lee CS, Kolman B (1995) Derotational femoral shortening for developmental dislocation of the hip: special indications and results in the child younger than 2 years. J Pediatr Orthop 15(6):768–779
Ireland J, Newman PH (1978) Triplane osteotomy for severely slipped upper femoral epiphysis. J Bone Joint Surg Br 60:390–393
Jerne R, Hansson G, Wallin J et al (1996) Long-term results after realignment operations for slipped upper femoral epiphysis. J Bone Joint Surg Br 78(5):745–750
Tylkowski CM, Rosenthal RK, Simon SR (1980) Proximal femoral osteotomy in cerebral palsy. Clin Orthop Relat Res 151:183–192
Payne LZ, DeLuca PA (1994) Intertrochanteric versus supracondylar osteotomy for severe femoral anteversion. J Pediatr Orthop 14(1):39–44
Svenningsen S, Terjesen T, Apalset K et al (1990) Osteotomy for femoral anteversion. A prospective 9-year study of 52 children. Acta Orthop Scand 61(4):360–363
Beauchesne R, Miller F, Moseley C (1992) Proximal femoral osteotomy using the AO fixed-angle blade plate. J Pediatr Orthop 12(6):735–740
Hau R, Dickens DR, Nattrass GR et al (2000) Which implant for proximal femoral osteotomy in children? A comparison of the AO (ASIF) 90 degree fixed-angle blade plate and the Richards intermediate hip screw. J Pediatr Orthop 20(3):336–343
Webb JA, Almaiyah M, McVie J et al (2008) Proximal femoral osteotomies in children using the Richards hip screw: techniques, outcome and subsequent removal. J Child Orthop 2(6):417–423. Epub 2008 Oct 2
Canale ST, Holand RW (1993) Coventry screw fixation of osteotomies about the pediatric hip. J Pediatr Orthop 3:592–600
Jay Zampini MD, James J, McCarthy MD (2009) Augmented blade plate fixation of a varus derotation osteotomy of the proximal femur using a tension band. Orthopedics 32(6):414
Engel EE, Volpon JB, Shimano AC (1997) Mechanical testing of the tension band wire fixation in the proximal femur. Arch Orthop Trauma Surg 116:266–270
Ito H, Minami A, Suzuki K, Matsuno T (2001) Three-dimensionally corrective external fixator system for proximal femoral osteotomy. J Pediatr Orthop 21(5):652–656
Khouri N, Khalife R, Desailly E et al (2010) Proximal femoral osteotomy in neurologic pediatric hips using the locking compression plate. J Pediatr Orthop 30(8):825–831
Rutz E, Brunner R (2010) The pediatric LCP hip plate for fixation of proximal femoral osteotomy in cerebral palsy and severe osteoporosis. J Pediatr Orthop 30(7):726–731
Joeris A, Audige L, Ziebarth K, Slongo T (2012) The locking compression paediatric hip plate: technical guide and critical analysis. Int Orthop 36(11):2299–2306
Szalay EA, Harriman D, Eastlund B et al (2008) Quantifying postoperative bone loss in children. J Pediatr Orthop 28(3):320–323
Schaefer MK, McCarthy JJ, Josephic K (2007) Effects of early weight bearing on the functional recovery of ambulatory children with cerebral palsy after bilateral proximal femoral osteotomy. J Pediatr Orthop 27(6):668–670
Albrektson J, Kay RM, Tolo VT et al (2007) Abduction pillow immobilization following hip surgery: a welcome alternative for selected patients. J Child Orthop 1(5):299–305. Epub 2007 Oct 13
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Islam, S.U., Henry, A., Khan, T. et al. The outcome of paediatric LCP hip plate use in children with and without neuromuscular disease. Musculoskelet Surg 98, 233–239 (2014). https://doi.org/10.1007/s12306-013-0308-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12306-013-0308-6