Abstract
Sitting is the main activity of daily living for the majority of patients with cerebral palsy. More than 60% of dependent sitters have hip disorders. Surgical management of hip and pelvic postural mal-alignment remains controversial.
The aim of this study was to investigate effectiveness of open hip release in patients with spastic hip deformities. Seventeen patients with spastic cerebral palsy were treated with a selective release of the adductors, hamstrings, and iliopsoas, and capsulotomy of the hip joint. There were 6 females and 9 males. Ten of the patients were nonambulatory and seven were ambulatory. The average age at operation was 6 years 4 months (4 to 14 years). The follow-up period ranges from 2 to 9 years (average of 4.8 years). The patients were evaluated clinically and radiologically. The migration and acetabular indices were measured on the pre-operative and follow-up radiographs.
The results of hip release were rated satisfactory in 12 patients and unsatisfactory in 5 patients. The latter was due to severe acetabular dysplasia and posterior instability that was later improved by acetabuloplasty.
We concluded that a soft tissue release of spastic hip deformities improved sitting stability in nonambulatory and walking posture in ambulatory patients.
Correspondence should be addressed to: Léana Fourie, CEO SAOA, PO Box 12918, Brandhof 9324 South Africa.
