Femoral derotation osteotomy in spastic diplegia

Pirpiris, M; Trivett, A; Baker, RJ; Rodda, J; Nattrass, GR; Graham, HK

Abstract

We describe the results of a prospective study of 28
children with spastic diplegia and in-toed gait,
who had bilateral femoral derotation osteotomies
undertaken at either the proximal intertrochanteric or
the distal supracondylar level of the femur. Preoperative
clinical evaluation and three-dimensional movement
analysis determined any additional soft-tissue surgery.
Distal osteotomy was faster with significantly lower
blood loss than proximal osteotomy. The children in the
distal group achieved independent walking earlier than
those in the proximal group (6.9 ± 1.3 v 10.7 ± 1.7 weeks;
p < 0.001). Transverse plane kinematics demonstrated
clinically significant improvements in rotation of the hip
and the foot progression angle in both groups.
Correction of rotation of the hip was from 17 ± 11°
internal to 3 ± 9.5° external in the proximal group and
from 9 ± 14° internal to 4 ± 12.4° external in the distal
group. Correction of the foot progression angle was from
a mean of 10.0 ± 17.3° internal to 13.0 ± 11.8° external in
the proximal group (p < 0.001) compared with a mean of
7.0 ± 19.4° internal to 10.0 ± 12.2° external in the distal
group (p < 0.001). Femoral derotation osteotomy at both
levels gives comparable excellent correction of rotation
of the hip and foot progression angles in children with
spastic diplegia.

Citation

Pirpiris, M., Trivett, A., Baker, R., Rodda, J., Nattrass, G., & Graham, H. (2003). Femoral derotation osteotomy in spastic diplegia. https://doi.org/10.1302/0301-620X.85B2.13342

• Journal Article Type: Article
• Publication Date: Jan 1, 2003
• Deposit Date: Jul 7, 2011
• Journal: The Journal of Bone and Joint Surgery
• Print ISSN: 0301620X
• Peer Reviewed: Peer Reviewed
• Volume: 85
• Issue: 2
• Pages: 265-272
• DOI: https://doi.org/10.1302/0301-620X.85B2.13342
• Publisher URL: http://dx.doi.org/10.1302/0301-620X.85B2.13342