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Orthopedic surgical interventions can be used to correct defects of the hip in patients with cerebral palsy. Potential problems include adduction deformity, flexion deformity, subluxation and dislocation.
In patients with an established dislocation of the hip, it is better to have a dislocated, mobile hip than one that is located but painful. Therefore, intervention should be considered only when the dislocation is recent and not accompanied by severe deformity of the femoral head or acetabular dysplasia.
The patient illustrated in the right panel has a hip adduction deformity. Interventions that might be employed in this patient include open or percutaneous lengthening of the adductors and/or an obturator neurectomy.
DeLuca PA. Common orthopedic problems II: the musculoskeletal management of children with cerebral palsy. Pediatr Clin N Am 1996;43:1135-50.