Article

The femoral derotation osteotomy (FDO) is seen as the golden standard treatment
in children with cerebral palsy and internal rotation gait. Variable outcomes
with cases of over- and undercorrection mainly in the less involved patients have
been reported. The determination of the amount of derotation is still
inconsistent. 138 patients (age: 11 (+/- 3.3) years) with cerebral palsy and
internal rotation gait were examined pre- and 1 year postoperatively after distal
or proximal FDO, using standardized clinical examination and 3D gait analysis.
Three groups were defined retrospectively depending on the amount of derotation
in relation to the mean hip rotation in stance (MHR) during gait analysis: Group
A (derotation angle > MHR + 10 degrees ), Group B (derotation angle = MHR +/- 10
degrees ), Group C (derotation angle <MHR-10 degrees ), and compared according to
their postoperative mean hip rotation. ANOVA with Bonferroni post hoc test was
used for statistics (p < 0.05). Group B had the greatest benefit with the highest
rate (86%) of good results (postoperative MHR = +/- 15 degrees ). In contrast
there were 14% cases of overcorrection and 5% cases of deterioration in Group A
with only 81% good results and only 79% good results in Group C. It can be
concluded, that it is less likely to have unsatisfactory outcomes if the amount
of FDO is defined according to the findings of gait analysis compared with
clinical examination.
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