الفهرس | Only 14 pages are availabe for public view |
Abstract Managing spastic hip dysplasia is an important part of caring for children with cerebral palsy because the natural history of dislocations is often pain by young adulthood, and because the salvage treatment.Hip subluxation typically begins between the ages of 2 and 6 years and is most common in children with the most severe cerebral palsy. Hip abduction, with the hips and knees extended, should be tested and recorded, and the MI and AI should be measured on the anteroposterior pelvic radiograph. Nonsurgical measures have not been successful in preventing progression. Soft-tissue lengthening should be done early, as soon as hip subluxation is recognized. Early comprehensive reconstructionis indicated if the hip cannot be adequately treated with muscle lengthening. Increasing evidence supports the efficacy of one-stage comprehensive treatment for the severely subluxated or dislocated hip. The approach includes soft-tissue lengthening; a shortening VDRO of the femur; and a pericapsular acetabuloplasty. A capsulotomy may be needed to adequately reduce the hip. Ideally, hip reconstruction should be done in patients 4 years of age or older but before permanent, advanced degenerative changes develop. |