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Unilateral varus osteotomy of the proximal femur in children with cerebral palsy : a five-year follow-up of the development of both hips

Larsson, Maria LU ; Hägglund, Gunnar LU and Wagner, Philippe LU (2012) In Journal of Children's Orthopaedics 6(2). p.51-145
Abstract

BACKGROUND: Varus osteotomy of the proximal femur (VOPF) is one treatment option to prevent hip dislocation in children with cerebral palsy (CP). It is questioned whether the osteotomy should be performed in the displaced hip only, or if it should be performed bilaterally to prevent later displacement of the contralateral hip. CPUP is a register and healthcare programme for children with CP that was initiated in 1994 in southern Sweden. In the programme, range-of-motion and radiographic examination of the hips is performed regularly. These data have been analysed preoperatively and for 5 years postoperatively in children treated with unilateral VOPF.

METHODS: Children with CP living in the counties of Skåne and Blekinge in the... (More)

BACKGROUND: Varus osteotomy of the proximal femur (VOPF) is one treatment option to prevent hip dislocation in children with cerebral palsy (CP). It is questioned whether the osteotomy should be performed in the displaced hip only, or if it should be performed bilaterally to prevent later displacement of the contralateral hip. CPUP is a register and healthcare programme for children with CP that was initiated in 1994 in southern Sweden. In the programme, range-of-motion and radiographic examination of the hips is performed regularly. These data have been analysed preoperatively and for 5 years postoperatively in children treated with unilateral VOPF.

METHODS: Children with CP living in the counties of Skåne and Blekinge in the south of Sweden, who were treated with unilateral VOPF at least 5 years ago, were included in the study. The degree of hip displacement and the range of hip motion were analysed preoperatively and after 5 years. Repeat hip operations after the index operation were recorded.

RESULTS: Twenty-four children fulfilled the inclusion criteria. Mean age at index operation was 7.6 (2.8-13.2) years. No child died within 5 years postoperatively, and no child was lost from follow-up. At follow-up after 5 years, 2 of the 24 children had been operated on with VOPF in the contralateral hip. The range of motion in both hips decreased, but the difference between the index hip and the contralateral hip did not change significantly.

CONCLUSION: Children with CP and unilateral hip displacement have a low risk of later contralateral displacement after being operated on with unilateral VOPF. This supports healthcare programmes that advocate unilateral VOPF in children with unilateral hip displacement.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebral palsy, Hip, Displacement, Osteotomy, Bilateral
in
Journal of Children's Orthopaedics
volume
6
issue
2
pages
7 pages
publisher
Springer
external identifiers
  • scopus:84861764742
ISSN
1863-2521
DOI
10.1007/s11832-012-0401-7
language
English
LU publication?
yes
id
d200d83e-3ea9-453d-93bf-b916c8f3e969 (old id 3913801)
date added to LUP
2017-04-03 14:52:56
date last changed
2017-04-09 04:56:16
@article{d200d83e-3ea9-453d-93bf-b916c8f3e969,
  abstract     = {<p>BACKGROUND: Varus osteotomy of the proximal femur (VOPF) is one treatment option to prevent hip dislocation in children with cerebral palsy (CP). It is questioned whether the osteotomy should be performed in the displaced hip only, or if it should be performed bilaterally to prevent later displacement of the contralateral hip. CPUP is a register and healthcare programme for children with CP that was initiated in 1994 in southern Sweden. In the programme, range-of-motion and radiographic examination of the hips is performed regularly. These data have been analysed preoperatively and for 5 years postoperatively in children treated with unilateral VOPF.</p><p>METHODS: Children with CP living in the counties of Skåne and Blekinge in the south of Sweden, who were treated with unilateral VOPF at least 5 years ago, were included in the study. The degree of hip displacement and the range of hip motion were analysed preoperatively and after 5 years. Repeat hip operations after the index operation were recorded.</p><p>RESULTS: Twenty-four children fulfilled the inclusion criteria. Mean age at index operation was 7.6 (2.8-13.2) years. No child died within 5 years postoperatively, and no child was lost from follow-up. At follow-up after 5 years, 2 of the 24 children had been operated on with VOPF in the contralateral hip. The range of motion in both hips decreased, but the difference between the index hip and the contralateral hip did not change significantly.</p><p>CONCLUSION: Children with CP and unilateral hip displacement have a low risk of later contralateral displacement after being operated on with unilateral VOPF. This supports healthcare programmes that advocate unilateral VOPF in children with unilateral hip displacement.</p>},
  author       = {Larsson, Maria and Hägglund, Gunnar and Wagner, Philippe},
  issn         = {1863-2521},
  keyword      = {Cerebral palsy,Hip,Displacement,Osteotomy,Bilateral},
  language     = {eng},
  number       = {2},
  pages        = {51--145},
  publisher    = {Springer},
  series       = {Journal of Children's Orthopaedics},
  title        = {Unilateral varus osteotomy of the proximal femur in children with cerebral palsy : a five-year follow-up of the development of both hips},
  url          = {http://dx.doi.org/10.1007/s11832-012-0401-7},
  volume       = {6},
  year         = {2012},
}