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The Journal of Bone and Joint Surgery, Vol 74, Issue 9 1347-1357, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
One-stage correction of the spastic dislocated hip. Use of pericapsular acetabuloplasty to improve coverage
SJ Mubarak, FG Valencia and DR Wenger
Orthopedic Department, Children's Hospital, San Diego, California.
We performed a combined one-stage approach for the treatment of eighteen
spastic subluxated or dislocated hips in eleven children who had cerebral
palsy. All patients were between five and thirteen years old and had
spastic subluxation or dislocation of the hip and severe acetabular
dysplasia. The operation consisted of release of the adductors, psoas, and
proximal hamstrings; a femoral-shortening varusderotation osteotomy; and a
pericapsular pelvic osteotomy. The pelvic osteotomy was designed to
increase superolateral coverage of the femoral head in the elongated
acetabulum, which had erosion of the superior and lateral aspects. At the
latest follow-up (mean duration, six years and ten months), seventeen of
the eighteen hips remained anatomically reduced.
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