Long-term development of overcorrection after femoral derotation osteotomy in children with cerebral palsy
Background - Recent studies showed rates of recurrence of internal rotation gait (IRG) after femoral derotation osteotomy (FDO) up to 40%. Some surgeons even advice overcorrection during FDO to avoid a later recurrence. - Research question - Evaluation of the long-term development of limbs with init...
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| Main Authors: | , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
31 January 2018
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| In: |
Gait & posture
Year: 2018, Volume: 61, Pages: 183-187 |
| ISSN: | 1879-2219 |
| DOI: | 10.1016/j.gaitpost.2018.01.012 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.gaitpost.2018.01.012 Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0966636218300122 
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| Author Notes: | Mirjam Niklasch, Matthias C. Klotz, Sebastian I. Wolf, Thomas Dreher |
| Summary: | Background - Recent studies showed rates of recurrence of internal rotation gait (IRG) after femoral derotation osteotomy (FDO) up to 40%. Some surgeons even advice overcorrection during FDO to avoid a later recurrence. - Research question - Evaluation of the long-term development of limbs with initial overcorrection after FDO. - Methods - 29 limbs of 20 children (9.9±3.2years at surgery) with IRG, cerebral palsy (CP) and more than 5° external hip rotation postoperatively were included retrospectively. A gait analysis and clinical examination were performed preoperatively (less than one year, E0), postoperatively (9-23 months, E1) and at the long-term follow-up (at least five years postoperatively, E2). Differences between those children that remained overcorrected at E2 and those with a hip rotation within normal range at E2 were evaluated. - Results - At E2 41% of these limbs remained overcorrected, 52% showed a hip rotation within normal range and 7% showed recurrence of IRG. A comparison of those limbs that remained overcorrected and those ending within normal range revealed neither a difference in age at surgery nor in static and dynamic torsional parameters at E0 and E1 except for pelvic rotation. A significantly larger pelvic internal rotation at E1 for those with remaining overcorrection could be identified. - Significance - A general overcorrection during FDO in children with CP to avoid recurrence of IRG cannot be recommended, as 41% remain overcorrected. Preoperative predictors for long-term development couldn't be identified. If pelvic mal-rotation is corrected, hip rotation may change into normal range over the time in combination with the development of a flexed knee gait. |
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| Item Description: | Gesehen am 06.03.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1879-2219 |
| DOI: | 10.1016/j.gaitpost.2018.01.012 |