Acta Chir Orthop Traumatol Cech. 2004; 71(5):281-287
[Palliative Schanz osteotomy for irreducible hip dislocation in adolescent patients with cerebral palsy].
- Ortopedicka klinika 2. LF UK a FN Motol - Dĕtská a dospĕlá ortopedie a traumatologie, Praha.
PURPOSE OF THE STUDY: Palliative Schanz osteotomy is one of the options for treatment of irreducible hip dislocation in adolescent patients with cerebral palsy.
MATERIAL: In 1992 to 2002, Schanz osteotomy was indicated on 46 occasions in 27 nonambulatory patients with the quadriplegic form of cerebral palsy aged 9 to 18 years.
METHODS: In the postoperative evaluation, emphasis was placed on the clinical presentation, i.e., improved motion of the hip joints and pain alleviation. X-ray examination was carried out at 2 to 6 months after surgery.
RESULTS: In all patients, the range of motion in the hip increased in abduction or flexion according to the osteotomy technique used. Because of severe pain, one patient (2.17 %) had to undergo subsequent resection of the femoral head. Transient pain in the hip persisted in four patients (8.7%).
DISCUSSION: In patients older that 10 years, reconstructive surgery for neurogenic dislocations has an uncertain outcome and a palliative procedure is often the only method of choice for treatment of irreducible dislocations. Schanz angulation osteotomy can provide a better range of motion, alleviate pain and facilitate the care of patients, particularly if they are nonambulatory.
CONCLUSIONS: Schanz osteotomy is a less invasive method than resection of the proximal femur and should be used preferably in older children with neurogenic hip dislocation in whom reconstructive surgery is not indicated.
Zveřejněno: 17. prosinec 2004 Zobrazit citaci