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Fucs, Patrícia Maria de Moraes Barros; Svartman, Celso; Assumpção, Rodrigo Montezuma César de; Kertzman, Paulo F

doi:10.1097/00004694-200307000-00021

Cited by 13 publications

(6 citation statements)

References 7 publications

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“…The surgical techniques used and analyzed in these selected articles were: hip arthroplasty ( n = 1) 12 ; Schanz femoral valgus osteotomy ( n = 1) 13 ; hip arthrodesis ( n = 1) 14 ; McHale valgus osteotomy ( n = 2) 15 , 16 and resection of the proximal end of the femur ( n = 6). 2 , 16 , 17 , 18 , 19 One study 11 compared two surgical techniques (resection of the proximal end of the femur and McHale valgus osteotomy) ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“… 10 Treatment decisions need to be based on careful individualized clinical observations on each patient. 14 , 20 …”

Section: Discussionmentioning

confidence: 99%

“…Only one of the studies used hip arthrodesis as an option for salvage surgery. 14 Fucs et al 14 evaluated the evolution (mean follow-up of five years and three months) of 14 patients who underwent unilateral arthrodesis. This sample was composed of four diplegic individuals, eight quadriplegic patients and two with a mixed pattern (diplegia and dyskinesia), with a mean age of 15 years and five months.…”

Section: Discussionmentioning

confidence: 99%

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Hip salvage surgery in cerebral palsy cases: a systematic review

Souza

Mansano

Bovo

et al. 2015

Revista Brasileira de Ortopedia (English Edition)

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Imbalance and muscle spasticity, in association with coxa valga and persistent femoral anteversion, compromises hip development in cases of cerebral palsy and may result in chronic pain and even dislocation. Some of these hips undergo salvage surgery because of the severe impact of their abnormalities in these patients’ quality of life. We conducted a systematic review of the literature to compare the results from the main hip salvage techniques applied to these individuals. The literature search focused on studies that evaluated results from hip salvage surgery in cases of cerebral palsy, published from 1970 to 2011, which are present in the Embase, Medline, PubMed, Cochrane Library and SciELO databases. Although the results were not statistically comparable, this systematic review demonstrates that hip salvage surgery should be indicated after individual evaluation on each patient, due to the wide spectrum of presentations of cerebral palsy. Therefore, it seems that no surgical technique is superior to any other. Rather, there are different indications.

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Section: Resultsmentioning

confidence: 99%

“… 10 Treatment decisions need to be based on careful individualized clinical observations on each patient. 14 , 20 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hip salvage surgery in cerebral palsy cases: a systematic review

Souza

Mansano

Bovo

et al. 2015

Revista Brasileira de Ortopedia (English Edition)

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“…Arthrodesis would not be indicated because this requires being affected unilaterally, weight-bearing function, and no spine involvement (Fucs et al 2003). Total hip arthroplasty has given satisfactory results in people with CP (Buly et al 1993, Gabos et al 1999), but would hardly be indicated in the severely handicapped non-ambulatory patients in our study.…”

Section: Discussionmentioning

confidence: 99%

Proximal femoral resection arthroplasty for patients with cerebral palsy and dislocated hips

Knaus

Terjesen

2009

Acta Orthopaedica

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Background and purpose Chronic hip dislocation in non-ambulatory individuals with cerebral palsy (CP) can lead to severe problems, of which pain is often the most severe. We studied the outcome of proximal femoral resection, especially regarding pain, sitting balance, perineal care, and patient satisfaction.Patients and methods During the period 1998–2005, we operated 20 non-ambulatory patients with spastic quadriplegic CP (8 females and 12 males). 13 patients had unilateral dislocation and 7 had bilateral. The mean age at operation was 15 (3–27) years. The indications for operation were chronic hip dislocation plus severe problems with pain (17 patients), perineal care (16), and sitting (10). Patients were followed from 1 to 6 years.Results 14 patients were satisfied with the surgery, 3 were dissatisfied, 2 were uncertain, and 1 patient had died 5 days postoperatively. Of the 15 patients who had suffered from considerable pain before surgery, 8 had complete relief from pain and 7 patients experienced improvement. Of the 2 patients who had had mild pain, 1 was unchanged and 1 patient deteriorated. All patients who had not been able to sit were able to sit after the surgery. Only 1 patient had difficulties with perineal hygiene at follow-up. Postoperative complications included deep vein thrombosis (1 patient) and edema, loss of appetite, and the need for gastrostomy (1 patient). 7 patients had prolonged pain for up to 6 months after surgery. 1 of these was reoperated because of persistent pain due to a bony-spike heterotopic ossification.Interpretation Most patients with chronic hip dislocation and severe pain or other major problems appear to benefit from proximal femoral resection. Pain, sitting ability, and perineal care improved and most patients and caregivers were satisfied.

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“…Radiologic measurements are commonly used for monitoring hip displacement. Reimer's migration percentage (MP)9 is a valid and reliable measure of lateral hip displacement and the most commonly used radiologic parameter 10-14…”

Section: Introductionmentioning

confidence: 99%

The Effect of Obturator Nerve Block on Hip Lateralization in Low Functioning Children with Spastic Cerebral Palsy

et al. 2014

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PurposeHip adductor spasticity has a great impact on developing hip displacement in children with cerebral palsy (CP). Obturator nerve (ON) block is less invasive intervention rather than soft tissue surgery for reduction of hip adductor spasticity. The aim of this study is to investigate the effect of ON block on hip lateralization in low functioning children with spastic CP.Materials and MethodsThe study was performed by retrospective investigation of the clinical and radiographic follow-up data of low functioning children [gross motor function classification system (GMFCS) level III to V] with spastic cerebral palsy whose hip was subluxated. Migration percentage (MP) was measured on hip radiographs and its annual change was calculated. In intervention group, ON block was done with 50% ethyl alcohol under the guidance of electrical stimulation.ResultsThe data of 49 legs of 25 children for intervention group and the data of 41 legs of 23 children for nonintervention group were collected. In intervention group, the MP were significantly reduced at 1st follow-up and the MPs at 2nd and last follow-up did not show significant differences from initial MP. Whereas in nonintervention group, the MPs at 1st, 2nd and last follow-up were all significantly increased compared to initial MPs.ConclusionON block with ethyl alcohol is useful as an early effective procedure against progressive hip displacement in these children with spastic CP.

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Untitled

Cited by 13 publications

References 7 publications

Hip salvage surgery in cerebral palsy cases: a systematic review

Hip salvage surgery in cerebral palsy cases: a systematic review

Proximal femoral resection arthroplasty for patients with cerebral palsy and dislocated hips

The Effect of Obturator Nerve Block on Hip Lateralization in Low Functioning Children with Spastic Cerebral Palsy

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