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Supracondylar femoral rotation osteotomy affects frontal hip kinetics in children with bilateral cerebral palsy


Thielen, Mirjam; Wolf, Sebastian I; Klotz, Matthias C M; Geisbüsch, Andreas; Putz, Cornelia; Krautwurst, Britta; Dreher, Thomas (2019). Supracondylar femoral rotation osteotomy affects frontal hip kinetics in children with bilateral cerebral palsy. Developmental Medicine and Child Neurology, 61(3):322-328.

Abstract

AIM:

To evaluate the influence of supracondylar femoral derotation osteotomy (FDO) on hip abduction muscle force and frontal hip moments in children with bilateral cerebral palsy.

METHOD:

For this retrospective cohort study 79 children (36 females, 43 males; mean age at surgery 11y [SD 3y]; range 4-17y) with bilateral cerebral palsy and preoperatively and 1-year postoperatively documented frontal hip moments who received supracondylar FDO in 134 limbs were included. The control group consisted of eight children (two females, six males; mean age 11y [SD 4y]; range 5-17y) who received single-event multi-level surgery without FDO.

RESULTS:

Hip joint impulse (p<0.001) and the first peak of frontal hip moments (p=0.003) increased, whereas the second peak decreased (p<0.001) from preoperatively to postoperatively. Hip abductor strength improved (p=0.001) from preoperatively to postoperatively.

INTERPRETATION:

Despite the compensatory mechanism, frontal hip moments are decreased preoperatively. Supracondylar FDO results in increased frontal hip moments. Changes in anteversion directly influence hip kinetics, although no direct change of the proximal bony geometry is performed.

Abstract

AIM:

To evaluate the influence of supracondylar femoral derotation osteotomy (FDO) on hip abduction muscle force and frontal hip moments in children with bilateral cerebral palsy.

METHOD:

For this retrospective cohort study 79 children (36 females, 43 males; mean age at surgery 11y [SD 3y]; range 4-17y) with bilateral cerebral palsy and preoperatively and 1-year postoperatively documented frontal hip moments who received supracondylar FDO in 134 limbs were included. The control group consisted of eight children (two females, six males; mean age 11y [SD 4y]; range 5-17y) who received single-event multi-level surgery without FDO.

RESULTS:

Hip joint impulse (p<0.001) and the first peak of frontal hip moments (p=0.003) increased, whereas the second peak decreased (p<0.001) from preoperatively to postoperatively. Hip abductor strength improved (p=0.001) from preoperatively to postoperatively.

INTERPRETATION:

Despite the compensatory mechanism, frontal hip moments are decreased preoperatively. Supracondylar FDO results in increased frontal hip moments. Changes in anteversion directly influence hip kinetics, although no direct change of the proximal bony geometry is performed.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Clinic for Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 March 2019
Deposited On:16 Jan 2020 09:55
Last Modified:16 Jan 2020 10:03
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0012-1622
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/dmcn.14035
PubMed ID:30255540

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