A Simple Method of Planning and Performing a Proximal Femoral Varus-Shortening-Derotation Osteotomy for Hip Dislocation in Cerebral Palsy Using a Blade-Plate

2000 ◽  
Vol 10 (4) ◽  
pp. 212-215
Author(s):  
R.A. Brooks ◽  
K. Kirby ◽  
T.N. Theologis
2021 ◽  
Author(s):  
Philippe Wagner ◽  
Gunnar Hägglund

Background and purpose — Hip surveillance in children with cerebral palsy (CP) includes repeated radiographic hip examinations and measurements of the hip migration percentage (MP) to identify hips in need of surgery early, to prevent dislocation with the fewest number of radiographic examinations possible. We analyzed the early development of the MP in hips operated on to prevent hip dislocation and hips stabilized without surgery Patients and methods — From the Swedish Surveillance Programme for CP, 5,899 radiographic measurements from 1,045 children with a Gross Motor Function Classification System level III–V born in 1996–2011 were analyzed. For children operated on to prevent hip dislocation, measurements up to the most recent preoperative radiograph were included. The hip with highest MP was analyzed for each child. A mixed-effects model was used to estimate the development of the MP at each age for each child and the population mean. Results — In the 702 children who did not undergo preventive surgery, the mean MP increased with decreasing velocity up to age 6 years. Here it reached 24% (95% confidence interval [CI] 24–25), with a velocity of 0.3%/year (CI 0.0–0.5), remaining approximately stable up to age 12 years. In the 343 children who underwent preventive surgery (219 adductor–psoas lengthening, 124 varus derotation osteotomy of proximal femur), the mean MP increased with an increasing velocity from a mean of 30% (CI 27–32) 3 years before the operation. Interpretation — An increasing rate of hip displacement in hips with an MP > 24% indicates the need for preventive surgery. Hips stabilized without preventive surgery had a decreasing displacement rate and were usually stabilized with an MP < 30% at age 6 years.


1987 ◽  
Vol 58 (6) ◽  
pp. 638-640 ◽  
Author(s):  
Cees F. A. Bos ◽  
Plet M. Rozing ◽  
Ab J. Verbout

1985 ◽  
Vol 33 (3) ◽  
pp. 759-762
Author(s):  
Shuji Nakamura ◽  
Itsuro Kaichi

Author(s):  
Francesco C Blumetti ◽  
José A Pinto ◽  
Brenda Nazaré Gomes Silva ◽  
Eiffel T Dobashi ◽  
Akira Ishida

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hyunjung Han ◽  
Jeong Ha Kim

PurposeThis study suggest the development of a wearable orthotic device pattern that can reduce pain and deformation, and help in the normal development of children with cerebral palsy. Such a pattern enables daily wear before hip subluxation occurs, to prevent hip dislocation and subluxation.Design/methodology/approachThis study set the design line by carrying out cell work on the actual model, then proceeded with the first pattern design. The final version of the second orthotic device was designed by conducting discussions with experts and the patient's guardian, with the device fitted to the child patient. The evaluation of the second orthotic device used the virtual model to check the pressure area and level through virtual fitting. An evaluation was then conducted with the device fitted to the child patient, to verify the functionality and suitability of the final pattern.FindingsFollowing the initial fitting evaluation, the second pattern was presented after modifying and supplementing issues such as movement suitability with posture change, position change of the great trochanter when wearing a diaper, pressure control of the X-shaped band on the genital area and thigh abduction. The master pattern of the final version of the second orthotic device was proposed after confirming that the femoral head of the hip joint was stably fixed, and the compression was applied through a verification based on the virtual fitting using the virtual model, and with the device fitted to the child patient.Originality/valueWith this study, it is expected that the process and design plan for the development of wearable orthotic device patterns for the persons with disabilities impaired mobility can be used as a basic resource to create devices that merge the clothing and medical fields.


2016 ◽  
Vol 49 ◽  
pp. 290-296 ◽  
Author(s):  
C. Putz ◽  
S.I. Wolf ◽  
A. Geisbüsch ◽  
M. Niklasch ◽  
L. Döderlein ◽  
...  

2014 ◽  
Vol 39 ◽  
pp. S38
Author(s):  
T. Dreher ◽  
M. Niklasch ◽  
S.I. Wolf ◽  
F. Braatz ◽  
K. Ziegler ◽  
...  

2015 ◽  
Vol 26 (1) ◽  
pp. 2-5
Author(s):  
Vinay Goyal ◽  
Nonica Laisram

Abstract Spastic cerebral palsy is the most common form of cerebral palsy. Spasticity in hip adductor causes discomfort, stiffness and difficulties in performing physical activities such as seating, transfers and walking. Grading of hip adductor spasticity is still a challenge in the field of rehabilitation. A simple method to assess hip adductor spasticity and use it as outcome measures of intervention is needed in general clinical practice. We propose a visual method for grading hip adductor spasticity i.e grade 1= touch at ankle, grade 2 = crossing at ankle and grade 3 = crossing at knee in spastic cerebral palsy children. We followed 60 spastic cerebral palsy children over a period of three months on oral antispastic medication and found it very useful to assess response to drug. Intially hip adductor spasticity of grade 3 was observed in 10 %, grade 2- 8.33%, grade 1- 26.66% and 45% patients had no scissoring. After three months of drug therapy improvement was observed as grade 3 seen in 1 %, grade 2 - 7%, grade 1 - 23.33% and patients with no scissoring rose to 63.3%. These observations show that visual method for hip adductor spasticity is a simple and helpful method for grading response to therapeutic intervention.


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