Children with neurological disorders often experience spasticity, which can cause issues for the hips. Varus derotation osteotomy can help.
Children with neurological disorders such as cerebral palsy, spina bifida, spinal muscular atrophy (SMA), muscular dystrophy and Charcot-Marie-Tooth disease can be at risk for hip dislocation.
Varus derotation osteotomy (VDRO) surgery places the ball back into the socket of the hip. The procedure helps prevent a partial or full hip dislocation.
Hip subluxation can result from spasticity, which also results in difficulty walking or an inability to walk at all.
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If the hip is more than 30% out of the socket, a pediatric orthopedist may suggest VDRO. A perched or partially dislocated hip leads to pain and limitation of motion, with increased risk of fractures.
VDRO surgery is performed by a pediatric orthopedist removing a small piece of bone from the femur to allow it to be angled properly in the socket.
Closed reduction VDRO places the femur head inside the socket without opening the capsule. An open reduction VDRO requires opening the capsule to restore the femur head.
The child typically is casted afterward. A reclining wheelchair and a special car seat will be needed to travel for a time after the surgery.
Pediatric orthopedic care for neurological disorders
Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine, provides specialized orthopedic care for children experiencing neurological conditions, such as spina bifida. Its physicians are a part of multidisciplinary teams for several specialized clinics for children with neurological conditions, including spina bifida and cerebral palsy.