Femoral head resection as a salvage procedure for the severely dysplastic hip in nonambulatory children with cerebral palsy.

BACKGROUND: Proximal femoral head resection (FHR) has been used as a treatment option in patients with cerebral palsy (CP) who suffer from pain, contractures, and impaired personal hygiene. We analyzed the overall functional outcome following this surgery and associated patient satisfaction.

METHODS: This study was a retrospective case series with a follow-on questionnaire. A consecutive sample of 27 patients with CP who underwent proximal FHR between 1988 and 2004 were analyzed. Medical and radiographic records were used alongside a patient satisfaction questionnaire. Average follow-up time was 7.8 years (range, 2.3-16.5 years).

RESULTS: We found an improvement in hip pain, range of motion, activities of daily living, and quality of life after surgery. Age at surgery, type of immobilization, and presence of heterotopic ossification or femoral migration did not affect the long-term surgical outcome.

CONCLUSION: This study confirms the efficacy of proximal FHR for the treatment of chronic severe neuromuscular hip dysplasia in children with CP.

LEVEL OF EVIDENCE: Level IV.