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Femoral derotation osteotomy in spastic diplegia

Pirpiris, M, Trivett, A, Baker, RJ, Rodda, J, Nattrass, GR and Graham, HK 2003, 'Femoral derotation osteotomy in spastic diplegia' , The Journal of Bone and Joint Surgery, 85 (2) , pp. 265-272.

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    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.

    Item Type: Article
    Themes: Health and Wellbeing
    Schools: Colleges and Schools > College of Health & Social Care
    Colleges and Schools > College of Health & Social Care > School of Health Sciences
    Journal or Publication Title: The Journal of Bone and Joint Surgery
    Publisher: British Editorial Society of Bone and Joint Surgery
    Refereed: Yes
    ISSN: 0301620X
    Depositing User: RH Shuttleworth
    Date Deposited: 07 Jul 2011 09:43
    Last Modified: 20 Aug 2013 17:59

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