Abstract
Purpose: Some patients with Cerebral Palsy who had a de-rotation osteotomy performed for correction of excessive anteversion had persistence of internal foot progression even after the surgery. The aim of this study was to see if there is any relationship between significant abductor weakness [less than Grade III: MRC] and persistence of internal foot progression.
Methods: We included all ambulatory patients with cerebral palsy who had had a de-rotation osteotomy between the periods of 2000 – 2005, who had also had a pre and post operative gait analysis, assessment of ante-version, muscle charting and hip range of movements.
There were 12 patients [17 hips, 5 bilateral] 5 male 7 female with an average age of 13. Seven were diplegic, two hemiplegic and three had asymmetric diplegia. Data was assessed using SPSS 13.0. As the data was found to be normally distributed the Fisher exact test and the Spearman’s Co-relation Coefficient was used.
Results: Of the 17 limbs operated, preoperative femoral anteversion was 20–60 degrees [mean: 45] and post op femoral anteversion was 0–35[mean: 15]. Of these 7 hips had persistent internal rotation gait on gait analysis. None of these patients with persistent internal rotation had any hip capsular contractures, and there was no significant change in abductor power after surgery.
On testing the hypothesis it was found that there is no relationship between weak hip abductors and persistent internal rotation. [Fisher exact test: p value: 0.8, r = -0.07]
Conclusion: Weak abductors may not be a cause of persistent internal rotation following de-rotation osteotomy. Weak abductor power is not a contraindication to de-rotation osteotomies and do not affect outcome of surgery.
Correspondence should be addressed to BSCOS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
