[Surgical treatment of the spastic hip luxation at patients with severe form of CP].

BACKGROUND

The aim of our study was the assessment the final results of the operative treatment of the luxated neurogenic hips at patients with severe form of CP.

MATERIALS AND METHODS

Analysis was performed on 13 CP patients with hemiplegia bilateralis treated in our department because of the neurogenic hip dislocation. At 5 patients (7 hips) was performed resection of femoral head according to Castle. At 9 patients (13 hips) the femoral osteotomy according to Schanz were done. The follow up ranged from 1 to 3 years. The early and late complications such as pain before and after surgery and nursing possibilities were analysed. The 4 questions concerned on the status before and after surgery. They assessed the pain, possibilities of crotch nursing and rehabilitation as well as total opinion about the final result of surgery.

RESULTS

At the group of patients after the resection of the femoral head two of them had no pain, one patients complained on the decreasing pain, and two hadn't any changes. Only three parents assessed the surgery as satisfactory. At the group after osteotomy according to Schanz six patients observed no pain, two complained on the decreasing pain and one didn't observe any changes. The possibilities of nursing improved at all patients in this group. Eight parents were satisfied and one dissatisfied after surgery. As late complications we have classified the following: ossification around the hip joint in one case and destabilization of the plate in one another.

CONCLUSIONS

The Schanz osteotomy permitted us to achieve the improvement in abduction of the hips at majority of the patients, the reduction of the pain and improvement in rehabilitation's possibilities. In our experience this method was more effective in the treatment of the luxated hips at patients with severe form of CP.