The Journal of Bone and Joint Surgery, Vol 67, Issue 8 1229-1235, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Femoral varus-derotation osteotomy in spastic cerebral palsy
MM Hoffer, GA Stein, M Koffman and M Prietto
Twenty children (twenty hips) with spastic cerebral palsy underwent femoral
varus-derotation osteotomy for which the principal indication was
inadequate coverage of the femoral head. Other infrequent indications
included pain, valgus angulation of the femoral neck, and dislocation of
the hip. The age at surgery ranged from four to fifteen years. Each child
had muscle releases before the osteotomy was done. At follow-up, at least
seven years later, the femoral head in twenty hips was well centered. Four
hips remained subluxated but were less subluxated than before the
osteotomy. One hip remained dislocated. The center-edge angle averaged -8
degrees preoperatively and +17 degrees at follow-up. The neck-shaft angle
averaged 155 degrees preoperatively, 114 degrees immediately
post-operatively, and 125 degrees at follow-up. Femoral varus-derotation
osteotomy, when combined with muscle releases, can allow children with
spastic cerebral palsy to maintain their ambulatory status and may decrease
pain about the hip.
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