AVN AFTER HIP RECONSTRUCTION IN CHILDREN WITH CEREBRAL PALSY
Spencer J, Lopis- Miro
Guy's & St. Thomas' NHS Trust, London UK
Raphael, Madrid, Spain

Between 1992 and 1997 seventy hip reconstructions were undertaken on 46 children (mean age 8 years) with four limb cerebral palsy. Length of follow-up varied between 2 and 5 years. Only 16 of the children underwent a radiographically controlled peri-acetabular osteotomy.

Seventy femoral heads were inspected at the time of open reduction. Twenty-two femoral heads showed flattening combined with other types of macroscopic damage. Five of these developed further deformation radiographically in the 2-5 year follow-up period. A total of 11 femoral heads out of 70 (16%) developed AVN and the migration percentage pre-operatively was higher in this group than in the group of children (59 femoral heads) that did not develop AVN. For debate is the question of whether radical dissection is the cause of AVN in these children's femoral heads after hip reconstruction and if so, can it be prevented?