Article

Internal hip rotation (IHR) is the major cause of intoeing gait in patients with
cerebral palsy (CP). Femoral derotation osteotomy (FDO)
is the preferred
treatment to correct excessive anteversion, however the condition may persist or
recur postoperatively. Retrospective clinical and kinematic evaluation of 75
spastic diplegic CP patients was conducted for a mean duration of 22 months
following proximal FDO. The patients were divided into two groups depending on
the correction or persistence of IHR evident at kinematics after surgery. If
corrected, mean patient follow-up was extended to 53 months. Outcomes were
analyzed using Two Proportions Equality, Mann-Whitney and Wilcoxon tests. IHR
persisted in 33.3% of cases at mean follow-up of 22 months and subtrochanteric
femur osteotomy was more frequent in this group (p=0.033). Thirty-five of the
fifty-four patients with first-round gait correction were monitored during the
extended follow-up. Those for whom IHR recurred (9.5%)
had undergone FDO at a
comparatively younger age. Patient gender, operations prior to or at the time of
femoral osteotomy, topographic classification, GMFCS level,
or the extent of
preoperative clinical and kinematic abnormalities had no apparent influence on
persistence or recurrence of abnormal gait.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

Langue : ANGLAIS