Should Proximal Femoral Implants be Removed Prophylactically or Reactively in Children With Cerebral Palsy?

Journal of Pediatric Orthopedics
Walter H TruongUnni G Narayanan

Abstract

Implants are commonly used to stabilize proximal femoral osteotomies in children with cerebral palsy (CP). Removal of implants is common practice and believed to avoid infection, fracture, or pain that might be associated with retained hardware. There is little evidence to support a prophylactic strategy over a reactive approach based on symptoms. The aim of this study was to compare the outcomes of prophylactic and reactive approaches to removal of proximal femoral implants in children with CP. An intention-to-treat model was used to compare 2 institutions that followed a prophylactic (within ∼1 y) and reactive (following complication/symptoms) approach to hardware removal, respectively. Patients with CP who had femoral implants placed at or before age 16, and had ≥2-year postsurgical follow-up were included. Demographics, surgical details, reasons for removal, and complications were recorded. χ and t tests were used. Six hundred twenty-one patients (prophylactic=302, reactive=319) were followed for an average of 6 years (range, 2 to 17 y). Two hundred eighty-seven (95%) implants were removed in the prophylactic group at 1.2 years. In the reactive group, 64 (20%) implants were removed at an average of 4.2 years. Reasons for re...Continue Reading

References

Jan 1, 1991·Journal of Pediatric Orthopedics·T P SchmalzriedF J Dorey
Jan 1, 1985·Journal of Pediatric Orthopedics·T R Highland, R L LaMont
Mar 1, 1994·Journal of Pediatric Orthopedics·W K Kahle
Mar 1, 1997·The Journal of Bone and Joint Surgery. British Volume·N BoosM E Müller
Jun 23, 2006·Journal of Pediatric Orthopedics·Randall T Loder, Judy R Feinberg
Sep 25, 2008·Journal of Pediatric Orthopedics·Ellen M RaneyHenry G Chambers
Jul 3, 2010·The Journal of Bone and Joint Surgery. British Volume·J R DavidsL I Pugh
Apr 25, 2012·Clinical Orthopaedics and Related Research·Ernest L SinkUNKNOWN Academic Network for Conservational Hip Outcomes Research Group
Apr 18, 2013·Orthopedics·L Johnson Patman, Elizabeth A Szalay
May 7, 2016·Journal of Pediatric Orthopedics·Matthew A Halanski

❮ Previous
Next ❯

Citations

Dec 29, 2020·The Journal of Bone and Joint Surgery. American Volume·Lindsay M Andras, Oussama Abousamra

❮ Previous
Next ❯

Related Concepts

Related Feeds

Birth Defects

Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.

Related Papers

Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
Anders MølsterArne Ekeland
The International Journal of Oral & Maxillofacial Implants
Anna-Kaisa AntalainenJan Wolff
© 2021 Meta ULC. All rights reserved