Rotational osteotomy with submuscular plating in skeletally
immature patients with cerebral palsy
- Affiliated Author(s)
- 송광순
- Alternative Author(s)
- Song, Kwang Soon
- Journal Title
- Journal of Orthopaedic Science
- ISSN
- 0949-2658
- Issued Date
- 2013
- Abstract
- Background: In cerebral palsy, intoeing gait with increased femoral anteversion is not uncommon and often requires surgical intervention. Although several conventional methods have been used, complications are common. We applied a new technique of rotational osteotomy with submuscular plating in skeletally immature patients with cerebral palsy.
Methods: Eighteen patients (26 femora, 8 bilateral) with a mean age of 8.7 years (range, 6–16) were prospectively treated with this technique. The anatomic distribution of patients was hemiplegia (n = 7), diplegia (n = 8), and asymmetric diplegia (n = 3). Percutaneous osteotomy was performed at the middle of the femoral shaft. After rotational correction, submuscular plating was done using a locking compression plate. Femoral anteversion was evaluated by a trochanteric prominence angle test (TPAT) and computed tomography.
Results: In all cases, each osteotomy healed in an average of 12 weeks (range, 10–14). The mean femoral anteversion by TPAT improved to 12° (range, 5°–30°) after surgery from 44° (range, 30°–65°) (p < 0.001). There were no complications of deep infection, implant failure, or limb length discrepancy over 1 cm.
Conclusions: In skeletally immature patients with cerebral palsy, femoral anteversion can be safely corrected using submuscular plating with a locking compression plate.
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