Femoral head resection for painful hip subluxation in cerebral palsy: Is valgus osteotomy in conjunction with femoral head resection preferable to proximal femoral head resection and traction?

Arabella I. Leet, Kimberlly Chhor, Franck Launay, Jane Kier-York, Paul David Sponseller

Research output: Contribution to journalArticle

Abstract

Patients with severe cerebral palsy who underwent either a femoral head resection with traction or a McHale procedure (femoral head resection and valgus osteotomy) were studied retrospectively and then contacted by telephone to assess whether removing the femoral head or proximal femur as a salvage procedure improved sitting tolerance, relieved pain, or improved hygiene. Twenty-seven patients (36 involved hips) were available for a retrospective chart and x-ray review, and over half (56%) of these patients or caretakers were able to complete a telephone questionnaire. Of the study cohort, 16 patients underwent femoral head resection with traction and 11 patients had a McHale procedure. The average age at surgery was 19 years and average follow-up was 3.4 years. For those in the McHale group, the length of stay in the hospital was shorter, the postoperative superior migration of the femoral head was less pronounced, and the surgical and medical complications were lower. The telephone survey showed that both groups had increased sitting tolerance and decreased pain, and both showed overall satisfaction with the surgical outcome.

Original languageEnglish (US)
Pages (from-to)70-73
Number of pages4
JournalJournal of Pediatric Orthopaedics
Volume25
Issue number1
DOIs
StatePublished - Jan 2005

Fingerprint

Traction
Cerebral Palsy
Osteotomy
Thigh
Hip
Telephone
Pain
Hygiene
Femur
Length of Stay
Cohort Studies
X-Rays
Surveys and Questionnaires

Keywords

  • Cerebral palsy
  • Femoral head resection
  • Painful hip
  • Subluxation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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title = "Femoral head resection for painful hip subluxation in cerebral palsy: Is valgus osteotomy in conjunction with femoral head resection preferable to proximal femoral head resection and traction?",
abstract = "Patients with severe cerebral palsy who underwent either a femoral head resection with traction or a McHale procedure (femoral head resection and valgus osteotomy) were studied retrospectively and then contacted by telephone to assess whether removing the femoral head or proximal femur as a salvage procedure improved sitting tolerance, relieved pain, or improved hygiene. Twenty-seven patients (36 involved hips) were available for a retrospective chart and x-ray review, and over half (56{\%}) of these patients or caretakers were able to complete a telephone questionnaire. Of the study cohort, 16 patients underwent femoral head resection with traction and 11 patients had a McHale procedure. The average age at surgery was 19 years and average follow-up was 3.4 years. For those in the McHale group, the length of stay in the hospital was shorter, the postoperative superior migration of the femoral head was less pronounced, and the surgical and medical complications were lower. The telephone survey showed that both groups had increased sitting tolerance and decreased pain, and both showed overall satisfaction with the surgical outcome.",
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AU - Launay, Franck

AU - Kier-York, Jane

AU - Sponseller, Paul David

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N2 - Patients with severe cerebral palsy who underwent either a femoral head resection with traction or a McHale procedure (femoral head resection and valgus osteotomy) were studied retrospectively and then contacted by telephone to assess whether removing the femoral head or proximal femur as a salvage procedure improved sitting tolerance, relieved pain, or improved hygiene. Twenty-seven patients (36 involved hips) were available for a retrospective chart and x-ray review, and over half (56%) of these patients or caretakers were able to complete a telephone questionnaire. Of the study cohort, 16 patients underwent femoral head resection with traction and 11 patients had a McHale procedure. The average age at surgery was 19 years and average follow-up was 3.4 years. For those in the McHale group, the length of stay in the hospital was shorter, the postoperative superior migration of the femoral head was less pronounced, and the surgical and medical complications were lower. The telephone survey showed that both groups had increased sitting tolerance and decreased pain, and both showed overall satisfaction with the surgical outcome.

AB - Patients with severe cerebral palsy who underwent either a femoral head resection with traction or a McHale procedure (femoral head resection and valgus osteotomy) were studied retrospectively and then contacted by telephone to assess whether removing the femoral head or proximal femur as a salvage procedure improved sitting tolerance, relieved pain, or improved hygiene. Twenty-seven patients (36 involved hips) were available for a retrospective chart and x-ray review, and over half (56%) of these patients or caretakers were able to complete a telephone questionnaire. Of the study cohort, 16 patients underwent femoral head resection with traction and 11 patients had a McHale procedure. The average age at surgery was 19 years and average follow-up was 3.4 years. For those in the McHale group, the length of stay in the hospital was shorter, the postoperative superior migration of the femoral head was less pronounced, and the surgical and medical complications were lower. The telephone survey showed that both groups had increased sitting tolerance and decreased pain, and both showed overall satisfaction with the surgical outcome.

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