Mubarak et al. describe a one-stage surgical approach for spastic subluxated or dislocated hips in children with cerebral palsy, combining soft-tissue releases, femoral-shortening varus-derotation osteotomy, and a pericapsular pelvic osteotomy designed specifically for the elongated, eroded acetabulum of neuromuscular hip disease — a morphology standard innominate osteotomies fail to address.
When you encounter a child with spastic cerebral palsy and a subluxated or dislocated hip with severe acetabular dysplasia (acetabular index >25°, open triradiate cartilage, age 5–16), this paper supports a combined one-stage approach — soft-tissue release, femoral-shortening varus-derotation osteotomy, and pericapsular acetabuloplasty — rather than standard innominate osteotomies, which are poorly matched to the elongated, superolaterally eroded acetabulum typical of neuromuscular disease.
The procedure is contraindicated in children ≤4 years, those whose subluxation can be controlled with soft-tissue procedures alone, and those with closed or near-closed triradiate cartilage or significant femoral head degeneration.
Mubarak et al. describe a one-stage surgical approach for spastic subluxated or dislocated hips in children with cerebral palsy, combining soft-tissue releases, femoral-shortening varus-derotation osteotomy, and a pericapsular pelvic osteotomy designed specifically for the elongated, eroded acetabulum of neuromuscular hip disease — a morphology standard innominate osteotomies fail to address.
When you encounter a child with spastic cerebral palsy and a subluxated or dislocated hip with severe acetabular dysplasia (acetabular index >25°, open triradiate cartilage, age 5–16), this paper supports a combined one-stage approach — soft-tissue release, femoral-shortening varus-derotation osteotomy, and pericapsular acetabuloplasty — rather than standard innominate osteotomies, which are poorly matched to the elongated, superolaterally eroded acetabulum typical of neuromuscular disease.
The procedure is contraindicated in children ≤4 years, those whose subluxation can be controlled with soft-tissue procedures alone, and those with closed or near-closed triradiate cartilage or significant femoral head degeneration.