COMBINED FEMORAL AND PERIACETABULAR OSTEOTOMY FOR DEGA TYPE SPASTIC HIP

Abstract

Purpose of the study: From 1999 to 2004, 16 patients (25 hips) aged 2–9 years (average 5±3 years) were treated for spastic hips. The patients were diplegic (n=19 hips, 76%) and tetraplegic (n=6 hips, 24%). Pure pyramidal cerebral palsy patients with no history of seizure.

Material and methods: The surgical plan was: femoral osteotomy, periacetabular osteotomy (San Diego), tenotomy of the adductors and psoas, anterior hip reduction as needed. Pain, range of abduction, Reimmer’s index and acetabular index were noted.

Results: In the diplegic patients, outcome was good (70%), fair (23%), poor (7%). In tetraplegic patients, outcome was good (20%), fair (20%), poor (60%). Complications were avascular necrosis (n=1) and decubitus lesions (n=2).