Proximal Femoral Derotational Osteotomy in a 14-Year-old Patient with Cerebral Palsy: Osteosynthesis Material Failure Three Weeks Postoperative
Nader Fadi, Yazbeck Rime, H. Fares Ali, Sleiman Mohamad Ali, Massaad Dounia, Massaad Antonella, Massaad Raymond
Asian Journal of Orthopaedic Research · pp. 309–315 · Published 30 Dec 2022
Abstract
Cerebral palsy (CP) is a group of disorders that affect a person's ability to move and maintain balance and posture. Excessive femoral internal rotation is one of the gait problems encountered and can be corrected by femoral derotation osteotomy. We present here the case of 14 years old boy, known to have cerebral palsy, with increased femoral anteversion treated with proximal subtrochanteric femoral de-rotation osteotomy fixed with plate and screws. He experienced a catastrophic failure of the plate. First time revision was done with a dynamic hip screw sliding plate, second time revision was done for pseudarthrosis and consisted of adding a dynamic compression plate (DCP) on the anterior cortex to increase the fixation stability. As a conclusion, a robust system should be utilized when trying to osteosynthesis fractures near spastic muscles, and tenotomy should be added whenever needed without hesitation.
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