Late-presenting Hip Dislocation in Non-ambulatory Children With Cerebral Palsy: A Comparison of Three Procedures
Cerebral Palsy, Spastic
About this trial
This is an interventional treatment trial for Cerebral Palsy, Spastic focused on measuring Cerebral palsy, McHale, dislocated hip, GMFCS IV, GMFCS V, Hip reconstruction surgery, HRS, Proximal femoral resection, valgus osteotomy
Eligibility Criteria
Inclusion Criteria:
- Lesion: neglected deformed dislocated hip (Deformed head Group B, C, and D according to Rutz classification modified from MCPHCS )
- Non-ambulatory: as defined by GMFCS level IV and V
Exclusion Criteria:
- Ambulatory patients
- patients underwent any previous hip bony procedures.
- Non-deformed Femoral head Group A according to Rutz classification
- Neuromuscular hip dislocation other than cp.
Sites / Locations
- Faculty of medicineRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
Active Comparator
Hip Reconstruction surgery.
Proximal femoral resection
Proximal femur valgus osteotomy
This group will undergo Hip reconstruction surgery Anterior approach overlying the iliac crest: open reduction and pelvic osteotomy. Lateral approach: derotation-varization osteotomy and shortening of femur and internal fixation.
This group will undergo PFR as described by resection of the proximal part of the femur below the level of the lesser trochanter by 2 to 3 cm and constructed a capsular flap across the acetabulum. The quadriceps muscle will be sutured around the resected end of the femur.
This group will undergo McHale Procedure.The patient is positioned in the lateral decubitus Position A straight incision is cantered over the greater trochanter and extends proximally. Head and neck are resected. A closing wedge, shortening, valgus-producing osteotomy of 40 to 50 degrees is marked just below the lesser trochanter and fixed by a plate.