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Salvage procedures for the painful chronically dislocated hip in cerebral palsy

Authors
 J. H. Hwang  ;  L. Varte  ;  H. W. Kim  ;  D. H. Lee  ;  H. Park 
Citation
 BONE & JOINT JOURNAL, Vol.98-B(1) : 137-143, 2016 
Journal Title
 BONE & JOINT JOURNAL 
ISSN
 2049-4394 
Issue Date
2016
MeSH
Adolescent ; Cerebral Palsy/complications* ; Child ; Chronic Disease ; Female ; Hip Dislocation/complications ; Hip Dislocation/diagnostic imaging ; Hip Dislocation/surgery* ; Humans ; Interpersonal Relations ; Male ; Musculoskeletal Pain/etiology ; Musculoskeletal Pain/surgery* ; Quality of Life ; Radiography ; Retrospective Studies ; Salvage Therapy/adverse effects ; Salvage Therapy/methods* ; Treatment Outcome ; Young Adult
Keywords
cerebral palsy ; femoral head resection ; hip dislocation ; proximal femoral resection arthroplasty ; subtrochanteric valgus osteotomy
Abstract
The aims of this study were to report functional outcomes of salvage procedures for patients with cerebral palsy (CP) who have chronic dislocation of the hip using validated scoring systems, and to compare the results of three surgical techniques. We reviewed 37 patients retrospectively. The mean age at the time of surgery was 12.2 years (8 to 22) and the mean follow-up was 56 months (24 to 114). Patients were divided into three groups: 14 who underwent proximal femoral resection arthroplasty (PFRA group 1), ten who underwent subtrochanteric valgus osteotomy (SVO group 2), and 13 who underwent subtrochanteric valgus osteotomy with resection of the femoral head (SVO with FHR group 3). All patients were evaluated using the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) and the Pediatric Quality of Life Inventory (PedsQL). Significant improvements occurred in most CPCHILD and PedsQL subsection scores following surgery in all patients, without significant differences between the groups. There were 12 post-operative complications. Less severe complications were seen in group 1 than in groups 2 and 3. Salvage surgery appears to provide pain relief in patients with CP who have painful chronic dislocation of the hip. The three salvage procedures produced similar results, however, we recommend the use of PFRA as the complications are less severe. TAKE HOME MESSAGE: Salvage surgery can be of benefit to patients with CP with chronic painful hip dislocation, but should be limited to selected patients considering complications.
Full Text
http://www.bjj.boneandjoint.org.uk/content/98-B/1/137
DOI
10.1302/0301-620X.98B1.35202
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyun Woo(김현우) ORCID logo https://orcid.org/0000-0001-8576-1877
Park, Hoon(박훈) ORCID logo https://orcid.org/0000-0002-8063-3742
Lee, Dong Hoon(이동훈)
Hwang, Jin Ho(황진호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146431
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