Safety of the LCP Pediatric Hip Plate in Proximal Femoral Osteotomy in Children with Cerebral Palsy

Omar Q Samarah,¹ Majd A Shaheen,² Rana A Tehabsim,² Bayan A Shaheen,² Marah B Makahleh,² Mahmoud M Almustafa,³ Fadi A Al hadidi,¹ Lutfi A Hussein,¹ Yazan S Hammad<sup>1

1</sup>Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan; ²School of Medicine, University of Jordan, Amman, Jordan; ³Department of Anesthesia, School of Medicine, University of Jordan, Amman, Jordan

Correspondence: Omar Q Samarah
Department of Special Surgery, School of Medicine, University of Jordan, Queen Rania Street, Amman, Jordan 11942 Tel +962 6 5353 444 ext. 2451
Fax +962 6 5353 338
Email o.samarah@ju.edu.jo

Purpose: Proximal femoral osteotomy in cerebral palsy patients is a demanding procedure. The fixation of the osteotomy can fail due to the weak osteoporotic bone. The LCP pediatric hip plate with its good grip makes these procedures safe. The aims of the present study are to evaluate the radiological outcome of proximal femoral osteotomy that was fixed with the pediatric LCP in cerebral palsy patients and to raise safety issues regarding its low rate of complications.
Patients and Methods: Sixteen patients with cerebral palsy who were operated in our department were included in this retrospective study. Data collected from medical charts and X-ray measurements retrospectively reviewed.
Results: In total, 16 patients (21 hips), ie, 9 males and 7 females, were included in this analysis. The mean age at the time of the index surgery was 11.9 years (5.9– 18.0). The mean follow-up period was 4.78 years (1.5– 8.0). Five patients had bilateral hip involvement and 11 had unilateral involvement. All patients had spastic cerebral palsy. The mean values of varus correction and de-rotation were 25° (0°– 45°) and 35° (20°– 50°), respectively. Neck shaft angle and the Reimer’s migration index were significantly improved postoperatively (p< 0.01 for both). Seventeen hips showed complete consolidation within 14 weeks of fixation and four hips needed 16 weeks. These four hips were in three patients who were 16 years of age or older. The correlation between age at surgery and the time needed for consolidation was statistically significant (p=0.005). Avascular necrosis, revision surgeries, failure of fixation, acetabular penetration, screw loosening or fracture of the femur were not seen in this study.
Conclusion: The LCP pediatric hip plate can be used safely in CP patients. The plate provides a strong stable fixation on osteoporotic bone with a low rate of complications.

Keywords: hip plate, neurological disorder, cerebral palsy, osteotomy, jordan