Effectiveness of femoral varus osteotomy in patients with cerebral palsy

Jeffrey J. Settecerri, Lori A. Karol

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

This is a retrospective review of 144 hips in 99 patients treated with femoral varus osteotomy between 1975 and 1995. Average follow-up was 5 years (range, 2-15 years). The majority of patients (67%) were nonambulatory spastic quadriparetics. The average age at the time of surgery was 7.7 years (range, 3-15 years). Radiographic parameters analyzed were the neck-shaft and center-edge (CE) angles and Reimer's migration index (MI). Results were considered good if the CE angle was >20°and the MI <30%, fair if the CE angle was 0°-20°and the MI 30-50%, and poor if the patient had persistent pain, a CE angle of <0°, or an MI >50%. Twelve hips (8%) remained painful at final follow-up, and 12 hips (8%) dislocated despite surgery. Previous surgery, unilateral surgery, performing a pelvic osteotomy, and age at the time of surgery had no statistical influence on outcome. Good results were obtained in 43.1%, fair in 41.5%, and poor in 15.4%. Only the quality of the reduction obtained at surgery, judged by the increase in CE angle and the reduction in MI, had a statistical influence on final result. Athetoid patients fared as well as those with spasticity. Femoral varus osteotomy was effective in providing a stable pain-free hip in 84% of patients.

Original languageEnglish (US)
Pages (from-to)776-780
Number of pages5
JournalJournal of Pediatric Orthopaedics
Volume20
Issue number6
DOIs
StatePublished - Jan 1 2000

Keywords

  • Cerebral palsy
  • Hip subluxation
  • Spastic quadriplegia
  • Varus osteotomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

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