Effectiveness of two methods of treatment of the spastic hip in CP children.

BACKGROUND Authors analysed the post-operative course of the hip joints in ICP children following two types of surgery. MATERIAL AND METHODS We analysed 50 children with CP (100 hips) treated in our department between 1999-2004 whose radiological records were complete. The children were divided into 2 groups of those following open adductor tenotomy and those treated according to Gob's method, i.e. by release of the flexion-adduction hip contracture. Hip joint stability was compared radiologically with the Reimers index. Consecutive radiographs were obtained at least 6 months apart and at least two radiographs were obtained in each patient. RESULTS In the first group, the Reimers index improved in 56 hips (70%), deteriorated in 14 hips (17.5%), and did not change in 10 hips (12.5%). In the second group, the index improved in 6 hips (30%), deteriorated in 4 hips (20%), and did not change in 10 hips (50%). CONCLUSIONS 1. Open adductor tenotomy may be an effective treatment for hip joint instability in cerebrally palsied children. 2. Continual monitoring of the Reimers index is a prerequisite for predicting the natural history of the spastic hip.