Clinical and radiological outcomes of surgical treatment for paralytic hip in cerebral palsy patients in Bogotá, Colombia
DOI:
https://doi.org/10.58814/01208845.29Keywords:
Hip Dislocation, Cerebral Palsy, Osteotomy, Muscle SpasticityAbstract
Introduction: Cerebral palsy (CP) causes an alteration of muscle tone and balance that may lead to paralytic hip dislocation (PHD), especially in the most severely affected patients.
Objective: To describe the clinical and radiological outcomes of patients with CP who underwent surgical treatment of PHD at the Instituto Roosevelt.
Methodology: Retrospective observational study performed on 92 patients aged 4 to 18 years with CP and PHD operated on between 2010 and 2014. Bivariate analyses were performed to compare clinical and radiological findings before and after the surgery to correct PHD using McNemar's test, Student's t-test, and Mann-Whitney U-test.
Results: The mean age was 7.45 years, 84.8% of the patients had spastic CP, and 59.8% were classified at level V of the Gross Motor Function Classification System. A total of 155 surgeries were performed in the 92 patients, the most frequent procedures being closed reduction and pelvic, femoral varus, and femoral derotation osteotomies. After surgery, pain, and difficulty in personal care, sitting and hip abduction decreased significantly (p<0.001). In addition, statistical differences were found between preoperative and postoperative radiological indices and angles.
Conclusion: Although a significant improvement was found in the clinical and radiological outcomes evaluated, reconstructive and salvage procedures predominated over preventive ones, thus making it necessary to strengthen follow-up and prevention programs for PHD and its complications in the institution in order to reduce morbidity in patients with CP.
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