Abstract
Over a 4 year period 27 children with cerebral palsy underwent proximal femoral derotation osteotomy resulting in a total of 42 operations performed. Each of these children had pre operative gait analysis performed followed by derotation osteotomy. The degree of derotation varied individually and was judged to be correct when the foot lay in a neutral position. Gait analysis was not repeated until 1 year after surgery to allow for complete bony union, recovery of the soft tissues and general patient rehabilitation. Pre-operative and post-operative data were compared to give a quantitative analysis of the actual derotation obtained.
The mean age at the time of operation was 9.7 years (range 4.5–14.5 years). The male : female ration was 6 : 5. the mean amount of femoral derotation achieved was 26.25 degrees (minimum 7 degrees, maximum 66 degrees). The goal of the operation was to correct internal rotation and achieve a hip in a neutral position throughout the majority of the gait cycle. The average hip rotation in a normal able-bodied person is 1.72 degrees of external rotation. 84% achieved more than 75% derotation to neutral. The remainder were considered operational failures.
These results quantitatively demonstrate that proximal femoral derotation osteotomy is a successful operation in cerebral palsy to correct intoeing.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at the Irish Orthopaedic Association, Secretariat, c/o Cappagh Orthopaedic Hospital, Finglas, Dublin
