Zamudio CJE, Legorreta CG

Language: Spanish
References: 15
Page: 70-75
PDF size: 136.52 Kb.

ABSTRACT

Background: Spasticity in patients with infantile cerebral palsy may lead to progressive subluxation and/or hip dislocation. Material and methods: Retrospective, cross-sectional trial of a cohort of patients with infantile cerebral palsy who underwent subtrochanteric osteotomy of the hip at the Shriner’s Hospital for children in Mexico City, with a 5-year follow-up. X-ray evaluation was conducted pre- and postoperatively and at the 5-year follow-up using the Settecerri classification. Results: Twenty cases were analyzed; mean age was 8.8 years. They included spastic quadriplegia, spastic diplegia, spastic paraplegia. Good results accounted for 50%, fair 30% and poor 20%. Good results in patients with quadriplegia represented 50%, with diplegia 25%, and with paraplegia 75%. Among patients undergoing single osteotomy, good results were 28%, fair 57%, and poor 14%; among those undergoing osteotomy plus cotyloplasty, good results were 63%, fair 9%, and poor 27%. Results with osteotomy plus soft tissues were good and fair in 50% of patients. Discussion: Spasticity and its effects are always present, regardless of surgery, treatment or no treatment; this is the reason for the recurrence of deformities or articular problems of the hip. The benefit of treatment cannot be denied despite spasticity. Conclusions: The best results were seen among the youngest patients with spastic diplegia and spastic paraplegia. Osteotomy as a single procedure is insufficient and therefore cotyloplasty is recommended.

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