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The Bone & Joint Journal

Children's Orthopaedics
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The Journal of Bone & Joint Surgery British Volume
Vol. 83-B, Issue 8 | Pages 1161 - 1167
1 Nov 2001
Owers KL Pyman J Gargan MF Witherow PJ Portinaro NMA

When cerebral palsy involves the entire body pelvic asymmetry indicates that both hips are ‘at risk’. We carried out a six-year retrospective clinical, radiological and functional study of 30 children (60 hips) with severe cerebral palsy involving the entire body to evaluate whether bilateral simultaneous combined soft-tissue and bony surgery of the hip could affect the range of movement, achieve hip symmetry as judged by the windsweep index, improve the radiological indices of hip containment, relieve pain, and improve handling and function.

The early results at a median follow-up of three years showed improvements in abduction and adduction of the hips in flexion, fixed flexion contracture, radiological containment of the hip using both Reimer’s migration percentage and the centre-edge angle of Wiberg, and in relief of pain. Ease of patient handling improved and the satisfaction of the carer with the results was high. There was no difference in outcome between the dystonic and hypertonic groups.


The Journal of Bone & Joint Surgery British Volume
Vol. 82-B, Issue 8 | Pages 1174 - 1176
1 Nov 2000
Bidwell JP Bennet GC Bell MJ Witherow PJ

We describe ten patients with Turner’s syndrome (karyotype 45, XO) who had leg lengthening for short stature. A high incidence of postoperative complications was encountered and many patients required intramedullary fixation as a salvage procedure. We discuss the reasons for this and highlight the differences between our findings and those of a similar series recently reported. In view of the considerable difficulties encountered, we do not recommend leg lengthening in Turner’s syndrome.