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Patients with poor able children have at least been able to recover the ability coordination and a poor sense of balance will thus to stand following appropriate surgical procedures. Even be deprived of the ability to maintain a standing this minimal skill can help improve daily nursing care position.
While the postoperative capability cannot common and can itself lead to stiffening of the hip be predicted for severely disable patients with a dislocated and to pain.
In our experience this procedure is indi- hip, we have not found any disadvantages resulting for cated only in extreme cases or after other treatments our patients as a result of the operation.
Actual freedom from pain cannot be consider that surgery is indicated also for severely dis- guaranteed however. Furthermore, the acetabulum in older compared to the head resection, although mobility children has little further opportunity of spontane- will continue to be restricted.
Children with hip replacement is made more difficult, and freedom motor disabilities are unable to compensate for the from pain is not always guaranteed with this method.
This proce- Reconstruction of the hip: dure will deprive them of the opportunity, possibly The dislocated can be surgically reconstructed. A even in the short term, to recover the ability to walk femoral derotation varus osteotomy together with or stand.
The overall results are better when all or lesser trochanter into the acetabulum.
The existing deformities of the pelvis and femur are cor- best results are achieved with the infracondylar re- rected. Bone corrections for the recon- struction of a dislocated hip in infantile spas- tic cerebral palsy: The femur is shortened, derotated and placed in a varus position.
The surgeon chisels around the acetabular groove and, after open reduction, turns down the acetabulum in this area.
After fixation of the femur, the lesser trochanter is secured to the pla- num trochantericum the iliopsoas transfer is only done in special indications, such as anterior dislocation 244 3.
We regularly perform these osteotomy with shortening, derotation and variza- steps in a single session on patients with poor coor- tion, a modified Dega-type acetabuloplasty, in dination and severe spasticity.
If the adductors are rare cases, a Salter or triple osteotomy, open reduc- still contracted at the end of the operation, they are tion with resection of the femoral head ligament and lengthened at the aponeurosis.
Our experience has shown that the transfer of the The patient is immobilized postoperatively in a hip iliopsoas to the planum trochantericum provides ad- spica or an abduction brace for 2—3 weeks in order to alleviate the pain.
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