ACETABULAR DEVELOPMENT AFTER FEMORAL OSTEOTOMY IN CEREBRAL-PALSY AFTER AGE 4 YEARS

Despite 651 adductor myotomies performed between 1977 and 1987 to prevent or treat hip displacement, in 28 tetraplegics, 35 femoral varus osteotomies had to be performed in addition after age 4 years. No patient had a long-standing dislocation and no acetabuloplasties were performed. Two patients with good results had to be excluded because measurement on radiographs was impossible. Seventeen operations were performed before and 16 after patients were aged 10 years. The preoperative condition was similar and the results were the same in the two groups. All 31 hips operated on achieved a smaller migration percentage (MP). The acetabular angle (AA) was improved in 21, and progression ceased in seven. One osteotomy had to be repeated after the review period. We showed that better development of the acetabular roof was still possible after age 10 years and that adequate stability of the hip was achieved in tetraplegic hips without long-standing dislocation and without the need for acetabuloplasty.