Proximal Femoral Derotational Osteotomy in a 14-Year-old Patient with Cerebral Palsy: Osteosynthesis Material Failure Three Weeks Postoperative
Published: 2022-12-30
Page: 309-315
Issue: 2022 - Volume 5 [Issue 2]
Nader Fadi *
Orthopaedics and Trauma, Universite Paris Cite, Paris, France and Orthopedic Surgery, Faculty of Medical Science, Lebanese University, Lebanon.
Yazbeck Rime
General Pediatrics, Saint George Hospital University Medical Center, Lebanon.
H. Fares Ali
Sport Surgery, Clinique Du Sport, Ramsay Sante, Paris, France and Orthopedic Surgery, Grenoble Alpes University, Grenoble, France.
Sleiman Mohamad Ali
Orthopedic Surgery, Faculty of Medical Science, Lebanese University, Lebanon.
Massaad Dounia
Orthopaedic Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Massaad Antonella
Orthopaedic Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Massaad Raymond
Orthopedic Surgery, West Bekaa General Hospital, Sohmor, Lebanon.
*Author to whom correspondence should be addressed.
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.
Keywords: Cerebral palsy, Femoral Derotation Osteotomy, plate osteosynthesis, failure, children