Spastic Hips in Cerebral Palsy - Retrospective Study of Salvage with the McHale Procedure
Abstract Objective To perform a retrospective and cross-sectional assessment to determine the pain and positional improvement of all patients with spastic cerebral palsy (CP) and severe hip deformity who underwent a McHale procedure in our center. A second objective was to analyze the potential com...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações Ltda.
2021-06-01
|
| Series: | Revista Brasileira de Ortopedia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162021000200244&tlng=en |
| _version_ | 1797225779625459712 |
|---|---|
| author | Helder Henzo Yamada Dante Galvanese Amato Neto Juliano Mangini Dias Malpaga Patricia Maria de Moraes Barros Fucs |
| author_facet | Helder Henzo Yamada Dante Galvanese Amato Neto Juliano Mangini Dias Malpaga Patricia Maria de Moraes Barros Fucs |
| author_sort | Helder Henzo Yamada |
| collection | DOAJ |
| description | Abstract Objective To perform a retrospective and cross-sectional assessment to determine the pain and positional improvement of all patients with spastic cerebral palsy (CP) and severe hip deformity who underwent a McHale procedure in our center. A second objective was to analyze the potential complications from the procedure. Methods All consecutive patients treated between 1995 and 2017 were analyzed. Clinically, the patients should present pain on hip mobilization, difficulty in positioning for sitting and hygiene care, and medical records with complete data; functionally was assessed through the Gross Motor Function Classification System (GMFCS). In the preoperative radiographs, we analyzed the migration percentage (MP), the type of deformity according to the Melbourne Cerebral Palsy Hip Classification Scale (MCPHCS), and the type of deformity of the femoral head. After the surgery, we assessed the proximal migration of the proximal femoral fragment, implant changes and/or failure, and potential heterotopic ossification. The outcomes were reported as successful (D1) in patients presenting remission of pain, painless mobility, and improved positioning, or unsuccessful (D2) in those presenting procedural failure that required a new surgery. Results In total, 47 patients (53 hips) were treated. Functionally, 43 patients were classified as GMFCS V (91%), 3 as GMFCS IV patients (6%), and 1 as GMFCS III (2%). The mean age was 13 years and 2 months. The follow-up ranged from 1 year to 15 years and 4 months, with an average of 4 years and 8 months. A total of 36 patients (41 hips) presented successful (D1) outcomes after the McHale procedure, corresponding to 77% of our cases, whereas 11 (23%) cases had unsuccessful (D2) outcomes. Conclusion The McHale procedure is a treatment option for GMFCS IV and V, but we must be aware of the potential complications. |
| first_indexed | 2024-03-08T08:10:03Z |
| format | Article |
| id | doaj.art-f4b7610cc2c0422ea06fed7e64e835f2 |
| institution | Directory Open Access Journal |
| issn | 1982-4378 |
| language | English |
| last_indexed | 2024-04-24T14:14:26Z |
| publishDate | 2021-06-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Revista Brasileira de Ortopedia |
| spelling | doaj.art-f4b7610cc2c0422ea06fed7e64e835f22024-04-03T08:57:01ZengThieme Revinter Publicações Ltda.Revista Brasileira de Ortopedia1982-43782021-06-0156224425010.1055/s-0040-1713391Spastic Hips in Cerebral Palsy - Retrospective Study of Salvage with the McHale ProcedureHelder Henzo Yamadahttps://orcid.org/0000-0002-6642-8005Dante Galvanese Amato Netohttps://orcid.org/0000-0002-6586-9511Juliano Mangini Dias Malpagahttps://orcid.org/0000-0001-9919-0665Patricia Maria de Moraes Barros Fucshttps://orcid.org/0000-0001-7081-987XAbstract Objective To perform a retrospective and cross-sectional assessment to determine the pain and positional improvement of all patients with spastic cerebral palsy (CP) and severe hip deformity who underwent a McHale procedure in our center. A second objective was to analyze the potential complications from the procedure. Methods All consecutive patients treated between 1995 and 2017 were analyzed. Clinically, the patients should present pain on hip mobilization, difficulty in positioning for sitting and hygiene care, and medical records with complete data; functionally was assessed through the Gross Motor Function Classification System (GMFCS). In the preoperative radiographs, we analyzed the migration percentage (MP), the type of deformity according to the Melbourne Cerebral Palsy Hip Classification Scale (MCPHCS), and the type of deformity of the femoral head. After the surgery, we assessed the proximal migration of the proximal femoral fragment, implant changes and/or failure, and potential heterotopic ossification. The outcomes were reported as successful (D1) in patients presenting remission of pain, painless mobility, and improved positioning, or unsuccessful (D2) in those presenting procedural failure that required a new surgery. Results In total, 47 patients (53 hips) were treated. Functionally, 43 patients were classified as GMFCS V (91%), 3 as GMFCS IV patients (6%), and 1 as GMFCS III (2%). The mean age was 13 years and 2 months. The follow-up ranged from 1 year to 15 years and 4 months, with an average of 4 years and 8 months. A total of 36 patients (41 hips) presented successful (D1) outcomes after the McHale procedure, corresponding to 77% of our cases, whereas 11 (23%) cases had unsuccessful (D2) outcomes. Conclusion The McHale procedure is a treatment option for GMFCS IV and V, but we must be aware of the potential complications.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162021000200244&tlng=encerebral palsyhip/deformitieship/surgery |
| spellingShingle | Helder Henzo Yamada Dante Galvanese Amato Neto Juliano Mangini Dias Malpaga Patricia Maria de Moraes Barros Fucs Spastic Hips in Cerebral Palsy - Retrospective Study of Salvage with the McHale Procedure Revista Brasileira de Ortopedia cerebral palsy hip/deformities hip/surgery |
| title | Spastic Hips in Cerebral Palsy - Retrospective Study of Salvage with the McHale Procedure |
| title_full | Spastic Hips in Cerebral Palsy - Retrospective Study of Salvage with the McHale Procedure |
| title_fullStr | Spastic Hips in Cerebral Palsy - Retrospective Study of Salvage with the McHale Procedure |
| title_full_unstemmed | Spastic Hips in Cerebral Palsy - Retrospective Study of Salvage with the McHale Procedure |
| title_short | Spastic Hips in Cerebral Palsy - Retrospective Study of Salvage with the McHale Procedure |
| title_sort | spastic hips in cerebral palsy retrospective study of salvage with the mchale procedure |
| topic | cerebral palsy hip/deformities hip/surgery |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162021000200244&tlng=en |
| work_keys_str_mv | AT helderhenzoyamada spastichipsincerebralpalsyretrospectivestudyofsalvagewiththemchaleprocedure AT dantegalvaneseamatoneto spastichipsincerebralpalsyretrospectivestudyofsalvagewiththemchaleprocedure AT julianomanginidiasmalpaga spastichipsincerebralpalsyretrospectivestudyofsalvagewiththemchaleprocedure AT patriciamariademoraesbarrosfucs spastichipsincerebralpalsyretrospectivestudyofsalvagewiththemchaleprocedure |