Evaluating Postoperative Immobilization Following Hip Reconstruction in Children With Cerebral Palsy

Abstract

Objectives Currently, there is no standardized protocol for postoperative immobilization techniques in patients with cerebral palsy undergoing hip reconstructive procedures. The purpose of this study was to evaluate the effects of several methods of postoperative immobilization and to determine which postoperative immobilization technique has the fewest complications. Materials and methods A retrospective cohort study of pediatric patients with cerebral palsy who underwent hip reconstructive procedures, in which a hip spica cast, Petrie cast, or abduction pillow was placed for postoperative hip immobilization, was conducted. Patients who underwent revision surgery and those without cerebral palsy were excluded from the analysis. The final cohort consisted of 70 cases. Demographics, laterality of surgery, procedure type, hip immobilization technique, and 30-day postoperative complications were recorded. Complications were defined as those related to casting immobilization, such as re-dislocation or loss of surgical fixation, and soft tissue complications, such as pressure ulcers or any superficial or deep wound infection. Results Of the 70 patients, 27 received spica casting, 28 received Petrie casting, and 15 received an abduction pillow. The complication rates, as defined in the methods section, were 14.8% for the spica cast group, 17.9% for Petrie cast, and 26.7% for abduction pillow. There was no significant difference in complication rates among spica cast, Petrie cast, or abduction pillow groups (P=0.76). Conclusions There was no significant difference in length of stay, pain control duration, or complication rates among the three methods of immobilization. Clinicians should be advised of the comparable outcomes among the postoperative immobilization techniques.

Bony hip reconstruction for displaced hips in patients with cerebral palsy: Is postoperative immobilization indicated?

“…In their case series, Tabaie et al 31 compared the complication rate of three different types of immobilization after hip reconstruction in CP, namely, hip spica, Petrie cast, and abduction pillow. Likewise, Vasconcellos et al 23 compared hip spica and abduction pillow.…”