Extreme femoral shortening: an approach to the chronically dislocated hip in the nonambulatory pediatric population

Jay V. Kalawadia, Ronak M. Patel, Layne Jensen, John Sarwark

Research output: Contribution to journalArticle

Abstract

There are many surgical techniques for treating the chronically dislocated, painful hip in patients with neuromuscular spasticity, but each has significant complication rates. We conducted a study to examine the outcomes of a novel technique, an extreme varus femoral shortening osteotomy, used in nonambulatory patients with neuromuscular spasticity. Patients who underwent the procedure were identified retrospectively by surgical codes. Medical records were reviewed for range of motion, pain and functional assessment, surgical indications, complications, and results. In addition, preoperative and postoperative radiographs were assessed, and caretaker questionnaires reviewed. Between 2001 and 2010, 1 surgeon performed 6 femoral shortening osteotomies in 5 nonambulatory patients with neuromuscular spasticity. In all 5 cases, there were improvements in pain, sitting tolerance, ease of hygiene, and ease of transfers at a minimum follow-up of 2 years (mean, 3.4 years). Postoperative complications included asymptomatic heterotopic ossification and recurrent subluxation. Extreme femoral shortening is a reproducible surgical technique that alleviates pain and makes hygiene easier in nonambulatory children with symptomatic hip dislocations caused by neuromuscular spasticity. Our complication rate was comparable to that of other procedures.

Original languageEnglish (US)
Pages (from-to)E200-E205
JournalAmerican journal of orthopedics (Belle Mead, N.J.)
Volume43
Issue number9
StatePublished - Sep 1 2014

ASJC Scopus subject areas

  • Medicine(all)

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