[Prevention of hip dislocation in children with cerebral palsy by early tenotomy of the adductor and psoas muscles].

Abstract

The effectiveness of early tenotomy of the psoas and adductor muscles for the prevention of dislocation of the hip dislocation in children with cerebral palsy precluding walking was studied in 40 hips in 24 children with severe disability. Age at the time of the procedure ranged from 1 1/2 years to 10 years. Results were evaluated by measuring Reimers' migration percentage (MP). Mean follow-up was three years. A satisfactory outcome (at least 10% improvement in MP at last follow-up) was seen in 67% of cases. The study of correlations with age and degree of displacement at surgery showed that results were satisfactory in 90% of children who had surgery before 4 years of age and whose MP was under 33%. To have preventive value, this procedure should be carried out at 2 years of age, before development of dislocation of the hip.