Results of muscle release for lateral hip migration in cerebral palsy

ABSTRACT

An adductor longus and gracilis muscle release procedure combined with anterior branch obturator neurectomy was reviewed in 36 children with cerebral palsy and lateral migration of the hip. The aim was to evaluate the results clinically, functionally and radiologically. There were 24 males and 12 females [average age 4.5 years]; 75% were diplegics, 22.2% quadroplegics and 2.8% hemiplegics. All the patients but one was spastics. The results have shown that muscle release with anterior branch obturator neurectomy was effective in improving or preventing further lateral migration of the hip. Subsequent adduction contracture developed in two cases [5.5%]. The results in the remaining patients were judged clinically satisfactory as abduction remained in an acceptable range. There was significant functional improvement in seven cases [16.6%]. The best results were achieved in Patients who were less than 6 years of age at the time of surgery. It was concluded that. management of lateral migration of the hip in cerebral palsied children by muscle release combined with anterior branch obturator neurectomy was safe and effective in preventing further migration