scholarly journals Neglected femoral neck fractures in cerebral palsy: a narrative review

2020 ◽  
Vol 5 (1) ◽  
pp. 58-64
Author(s):  
Giuseppe Toro ◽  
Antimo Moretti ◽  
Marco Paoletta ◽  
Annalisa De Cicco ◽  
Adriano Braile ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Femoral Neck ◽  
Motor Function ◽  
Treatment Options ◽  
High Morbidity ◽  
Fibular Graft ◽  
Motor Impairments ◽  
High Prevalence ◽  
Neck Fracture

Hip fractures are severe conditions with a high morbidity and mortality, especially when the diagnosis is delayed, and if formulated over 30 days after the injury, is termed a ‘neglected femoral neck fracture’ (NFNF). Cerebral palsy (CP) is probably one of the major risk factors for NFNF in Western countries, mainly because of both cognitive and motor impairments. However, considering the high prevalence of fractures in these patients, the incidence of NFNF in this population is probably underestimated, and this condition might result in persistent hip or abdominal pain. Several techniques are available for the treatment of NFNF (i.e. muscle pedicle bone graft, fixation with fibular graft, valgisation osteotomy), but most of them could affect motor function. Motor function must be preserved for as long as possible, in order to enhance the quality of life of CP patients. After discussing published NFNF cases in CP patients and available treatment options, a practical approach is proposed to facilitate the orthopaedic surgeon to both early identify and appropriately manage these challenging fractures. Cite this article: EFORT Open Rev 2020;5:58-64. DOI: 10.1302/2058-5241.5.190019

scholarly journals Principles of Valgus Intertrochanteric Osteotomy (VITO) after Femoral Neck Nonunion

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
D. Banaszek ◽  
D. Spence ◽  
P. O’Brien ◽  
K. Lefaivre
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Proximal Femur ◽  
Treatment Options ◽  
Intertrochanteric Osteotomy ◽  
Valgus Osteotomy ◽  
Challenging Problem ◽  
The Individual ◽  
Technical Considerations

Nonunion is a relatively rare, yet challenging problem after fracture of the femoral neck. Risk factors include verticality of the fracture line and presence of comminution of the posteromedial calcar, as well as quality of reduction. Treatment options consist of valgus intertrochanteric osteotomy versus arthroplasty. Treatment should be tailored to the individual patient, taking into account patient age and activity demands. This review outlines the principles and technical considerations for valgus osteotomy of the proximal femur in the setting of femoral neck nonunion.

scholarly journals Motor Function Predicts Parent-Reported Musculoskeletal Pain in Children with Cerebral Palsy

2013 ◽  
Vol 18 (6) ◽  
pp. 323-327 ◽  
Author(s):  
Chantel C Barney ◽  
Linda E Krach ◽  
Patrick F Rivard ◽  
John L Belew ◽  
Frank J Symons
Keyword(s):  
Cerebral Palsy ◽  
Activities Of Daily Living ◽  
Musculoskeletal Pain ◽  
Motor Function ◽  
Daily Living ◽  
Brief Pain Inventory ◽  
Self Report ◽  
General Description ◽  
Motor Impairments ◽  
Gmfcs Level

BACKGROUND: The relationship between pain and motor function is not well understood, especially for children and adolescents with communication and motor impairments associated with cerebral palsy (CP).OBJECTIVES: To determine whether a predictive relationship between motor function and musculoskeletal pain exists in children with CP.METHODS: Following informed consent, caregivers of 34 pediatric patients with CP (mean [± SD] age 9.37±4.49 years; 80.0% male) completed pain- and function-related measures. Parents completed the Dalhousie Pain Interview and the Brief Pain Inventory based on a one-week recall to determine whether pain had been experienced in the past week, its general description, possible cause, duration, frequency, intensity and interference with daily function. The Gross Motor Function Classification System (GMFCS) was used to classify the motor involvement of the child based on their functional ability and their need for assistive devices for mobility.RESULTS: GMFCS level significantly predicted parent-reported musculoskeletal pain frequency (P<0.02), duration (P=0.05) and intensity (P<0.01). Duration of pain was significantly related to interference with activities of daily living (P<0.05).CONCLUSIONS: Children with CP with greater motor involvement, as indexed by GMFCS level, may be at risk for increased pain (intensity, frequency and duration) that interfers with activities of daily living. The clinical index of suspicion should be raised accordingly when evaluating children with developmental disability who cannot self-report reliably.

scholarly journals Caregiver-reported health-related quality of life of children with cerebral palsy and their families and its association with gross motor function: A South Indian study

2016 ◽  
Vol 07 (02) ◽  
pp. 223-227 ◽  
Author(s):  
S. Surender ◽  
Vykuntaraju K. Gowda ◽  
K. S. Sanjay ◽  
G. V. Basavaraja ◽  
Naveen Benakappa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cerebral Palsy ◽  
Motor Function ◽  
Classification System ◽  
Health Related Quality ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Related Quality ◽  
Health Related

ABSTRACT Introduction: In children, health-related quality of life (HRQOL) includes parental impact and family functioning along with concepts of illness, functional status, mental health, and comfort. We are focusing on the impact of cerebral palsy (CP) on children’s HRQOL and their families, and its relationship with gross motor dysfunction. Subjects and Methods: CP children aged 3–10 years under regular neurology follow-up were enrolled. The HRQOL and motor severity were prospectively assessed using lifestyle assessment questionnaire-CP and gross motor function classification systems, respectively. Results: One hundred children participated in this study. Thirty-three percent of children had good, 22% had mildly affected, whereas 45% had moderately to severely affected HRQOL. A significant association is present between gross motor function classification system and HRQOL. Conclusion: HRQOL in CP and their caregivers is highly impaired. The degree of impairment is associated with physical independence, mobility, clinical burden, and social integration dimensions. Therapies targeting these dimensions and associated comorbidities will improve the HRQOL. Gross motor function classification system is a good indicator of HRQOL.

Free vascularized fibular graft for treatment of pathological femoral neck fracture and osteonecrosis of the femoral head: A case report with a long-term follow-up

Microsurgery ◽  
2008 ◽  
Vol 29 (3) ◽  
pp. 240-243 ◽  
Author(s):  
Alexandros E. Beris ◽  
Marios G. Lykissas ◽  
Alexandros Payatakes ◽  
Vasileios A. Kontogeorgakos ◽  
Alexandros Mavrodontidis ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Femoral Neck ◽  
Fibular Graft ◽  
Vascularized Fibular Graft ◽  
Long Term Follow Up ◽  
Neck Fracture ◽  
Free Vascularized Fibular Graft
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