Article

External femoral derotation osteotomy (FDO) is an orthopaedic intervention to
correct increased femoral anteversion and associated excessive internal hip
rotation and internal foot progression during gait in children with cerebral
palsy. The resulting functional issues may include clearance problems and hip
abductor lever-arm dysfunction. The purpose of this study was to evaluate
long-term gait outcomes of FDO. Twenty ambulatory patients (27 sides) with
cerebral palsy who underwent pre-operative (P0) and a one year post-operative
(P1) gait analysis as part of the standard of care had a second post-operative
analysis (P2) approximately 11 years post-surgical intervention. Mean hip
rotation in stance showed statistically significant decreases in internal
rotation at P1 post-surgical intervention that were maintained long-term (mean
hip rotation P0: 21+/-9, P1: 0+/-9 and P2: 6+/-12 degrees internal). Similar
results were seen with mean foot progression (P0: 9+/-16 degrees internal, P1:
14+/-13 degrees external, P2: 13+/-16 degrees external). However, 2/27 sides (9%)
showed a recurrence of internal hip rotation of >15 degrees at the 11year follow-up. The reasons for this recurrence could include age, surgical location
and ongoing disease process all of which need to be further examined. We conclude
that FDO can show long-term kinematic and functional benefits when performed in
the prepubescent child with cerebral palsy in comparison to the natural
progression of of hip rotation in cerebral palsy.
CI - Copyright (c) 2017 Elsevier B.V. All rights reserved.

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