International Orthopaedics

, Volume 18, Issue 5, pp 313–316

Surgical prevention of paralytic dislocation of the hip in cerebral palsy

  • G. Čobeljić
  • Z. Vukašinović
  • I. Djorić
Article

Summary

Paralytic dislocation of the hip in cerebral palsy may be prevented by soft tissue surgery and the results of two procedures are reported. Twenty hips were treated by adductor tenotomy alone and this was unsuccessful in every case. An alternative method was carried out in 42 hips in 25 patients. The procedure combined adductor tenotomy with release of the hip muscles including iliac crest resection, tenotomy of the rectus femoris, recession of the iliopsoas and, when necessary, either release or transposition of the knee flexors. This was much more successful in decreasing migration of the femoral head.

Résumé

Dans la paralysie cérébrale la luxation de la hanche peut être efficacement évitée grâce à des interventions chirurgicales portant sur les parties molles. Nous avons étudié les résultats de deux types d'opération: la ténotomie des adducteurs et cette même opération associée à la désinsertion de la hanche (avec transposition du psoas sur la partie proximale de la capsule) et éventuellement avec allongement des fléchisseurs du genou ou transposition de ceux-ci sur la partie distale du fémur. Soixante-deux hanches ont été opérées chez 45 malades. Les résultats de la ténotomie isolée des adducteurs ont été insuffisants dans les 20 cas opérés (âge moyen au moment de l'opération, 4, 5, ans, recul 6,5 ans). Les résultats du deuxième type d'intervention ont été meilleurs dans les 42 hanches opérées, le pourcentage migratoire de la tête fémorale a été réduit de 45% (âge moyen lors de l'opération 7 ans, recul 5 ans). Plus de la moitié des malades étaient capables de se déplacer.

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Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • G. Čobeljić
    • 1
  • Z. Vukašinović
    • 1
  • I. Djorić
    • 1
  1. 1.Special Hospital for Orthopaedic Surgery ‘Banjica’, Belgrade Medical FacultyUniversity of BelgradeYugoslavia
  2. 2.S. O. H. B. ‘Banjica’BeogradYugoslavia

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