Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri.
Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
JBJS Rev. 2020 Mar;8(3):e0148. doi: 10.2106/JBJS.RVW.19.00148.
Hip disorders are the second most common musculoskeletal abnormality seen in children with cerebral palsy, affecting nearly 1 in 3. The goal of surgical intervention is to provide a mobile, located, and painless hip. Reconstructive procedures are indicated for children with migration percentages of >40%. Reconstructive procedures typically result in a long-term satisfactory outcome, although recurrence is seen particularly in nonambulatory children and when the reconstruction is performed earlier than 6 years of age. Salvage procedures are performed when reconstructive procedures are no longer an option and degenerative changes have occurred. They include proximal femoral valgus osteotomy, proximal femoral resection, and hip arthroplasty.
髋关节疾病是脑瘫患儿中第二常见的肌肉骨骼异常，影响近三分之一的患儿。手术干预的目标是提供一个活动、定位和无痛的髋关节。对于迁移百分比>40%的儿童，需要进行重建手术。重建手术通常会产生长期满意的结果，但在非步行儿童中以及重建手术在 6 岁之前进行时，复发的情况较为常见。当重建手术不再可行且发生退行性变化时，需要进行挽救性手术。这些手术包括股骨近端外翻截骨术、股骨近端切除术和髋关节置换术。
