Treatment of limb deformities in patients of Ollier's disease with Ilizarov technique
Resource
Journal of the Formosan Medical Association v.100 n.4 pp.250-256
Journal
Journal of the Formosan Medical Association
Journal Volume
v.100
Journal Issue
n.4
Pages
250-256
Date Issued
2001
Date
2001
Author(s)
WU, CHUNG-TING
HUANG, SHIER-CHIEG
Abstract
Background and Purpose: Progressive subluxation and dislocation of the hip are major complications in patients with cerebral palsy (CP), causing functional deterioration and difficulties in personal hygiene . Treatment of these problems is difficult and complicated. The purpose of this stucy was to describe the surgical results and long-term follow-up in a group of cp patients. Methods: Twenty-three CP patients with subluxated (15 hips) or dislocated hips (12 hips) underwent corrective surgery between 1985 and 1993. This included 11 quadriplegic, eight diplegic, and four hemiplegic patients. Before surgery, four patients were bed- ridden, eight were sitters, six were house-ambulators, and five were community-ambulators. The average age at surgery was 8 years and 5 months. The surgical procedures consisted of femoral varus derotational osteotomy in 21 patients (25 hips), selected soft tissue release in 18 patients (22 hips) , and pelvic osteotomy in 18 patients (20 hips). The center- edge angle, acetabular index, and neck-shaft angle were used as parameters to evaluate preoperative and post operative radio-graphic chnges. Results: After an average follow-up of 4.8 years, 19 patients (80%) (22 hips) gained stability of the hips, and also improvement in functional status. The four bed-ridden patients all became sitters; six of the eight sitters became house-ambulators and one became a community- ambulator; all six house- ambulators became community-ambulators, and the five community-ambulators had functional improvement. Complications included nonunion at the femoral osteotomy site in one hip, redislocation in two hips, and resubluxation in one hip. Conclusions: We conclude that subluxated or dislocated hips in patients with CP can be effectively treated with aggressive correction, which mayinclude soft tissue release, femoral derotational osteotomy, and pelvic osteotomy for improvement of hip range of motion and functional status.
Subjects
cerebral palsy
subluxation
dislocation
hip
surgery