Bleck E E
Orthop Clin North Am. 1980 Jan;11(1):79-104.
Orthopedic surgery can alleviate the hip flexion, adduction, and medial rotation deformities of the hip and improve the function and appearance of gait. To accomplish this, however, careful examination and prudence in the operative procedure to avoid overdoing and overcorrecting are important. Orthopedic surgery can prevent subluxation and dislocation of the hip before the age of seven years, and consequently repetitive radiographic examinations of the hip in children who have spastic paralysis of the hip musculature should be a routine procedure. Subluxation and dislocation of the hip, when established, can be successfully treated with orthopedic surgical procedures. Physicians must keep in mind that the spastic paralysis of cerebral palsy originates in the brain, and therefore the spasticity cannot be eliminated. The best that can be done is to weaken or remove some muscles as deforming forces and to achieve compromises for continued function. The goal should be optimal independence for the child and adolescent during development, and freedom from pain with deteriorating function due to degenerative arthritis in the adult.
矫形外科手术可以缓解髋关节的屈曲、内收和内旋畸形，并改善步态功能和外观。然而，要做到这一点，仔细检查并在手术过程中谨慎操作以避免过度治疗和过度矫正非常重要。矫形外科手术可以预防7岁前髋关节的半脱位和脱位，因此，对于患有髋部肌肉痉挛性麻痹的儿童，应常规进行髋关节的重复X线检查。髋关节一旦出现半脱位和脱位，可以通过矫形外科手术成功治疗。医生必须牢记，脑瘫的痉挛性麻痹起源于大脑，因此痉挛无法消除。所能做的最好的事情是削弱或去除一些作为变形力的肌肉，并为持续功能达成妥协。目标应该是让儿童和青少年在发育过程中实现最佳的独立性，并在成年后避免因退行性关节炎导致功能恶化而产生疼痛。
