Article

The purpose of this study was to systematically review the current literature to
determine the effect of a femoral derotation osteotomy (FDRO) on hip and pelvic
rotation kinematics during gait compared to no intervention in children with
spastic cerebral palsy (CP). We performed a systematic search for prospective and
retrospective cohort studies of children with CP, who were treated with a FDRO,
and were assessed with pre and post surgery three-dimensional gait analysis.
Medline, CINAHL, EMBASE, the Cochrane Library and Web of Science were searched up
to December 2013. Data sources were prospective and retrospective studies. Mean
differences were calculated on pooled data for both pelvic and hip rotation
kinematics. Thirteen of 196 articles met the inclusion criteria (5 prospective, 8
retrospective). All included studies were of sufficient quality for meta-analysis
as assessed using a customised version of the STROBE checklist. Meta-analysis
showed that FDRO significantly reduced pelvic retraction by 9.0 degrees and hip
internal rotation by 17.6 degrees in participants with unilateral CP involvement
and hip internal rotation by 14.3 degrees in participants with bilateral CP
involvement. Pelvic symmetry in children with unilateral spastic CP is
significantly improved by FDRO. Patients with bilateral involvement do not
improve their transverse plane pelvic rotation profiles during gait as a result
to FDRO, although this result should be interpreted with caution due to the
heterogeneous nature of these participants and of the methods used in the studies
assessed.
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Langue : ANGLAIS