8-Year-Old Child with Cerebral Palsy Treated with Pelvic Osteotomies Using 3.5 mm Blade Plate Having Subsequent Bilateral Implant Aseptic Loosening: A Case Report

  • Ahmed Nahian California Baptist University - Lake Erie College of Osteopathic Medicine
  • Julieanne P. Sees Nemours Alfred I. duPont Hospital for Children
Keywords: Cerebral palsy, Hip dislocation, Osteotomy, Gait, Acetabuloplasty, Bone anteversion

Abstract

Background: Cerebral palsy (CP) is a central problem of the brain due to neurological insult that affects muscle posture, tone, and movement, resulting in poor motor control and dysfunctional muscle balance affecting hip joints in the growing child. Surgical treatment of hip and, if present, acetabular dysplasia addresses the femoral neck-shaft angle, appropriate muscle lengthening, and deficiency of acetabular coverage, as necessary. The surgeons perform proximal femoral osteotomies (PFOs) mostly with fixed angled blade plates (ABP) with proven success. The technique using an ABP is common and requires detailed attention to perform and to teach. 

The case: In this case, an eight-year-old ambulatory patient with CP underwent bilateral proximal varus femoral derotational and pelvic osteotomies for the neuromuscular hip condition with a 3.5 mm Locking Cannulated Blade System (OP-LCP) by OrthoPediatrics Corp instead of the use of the conventional 4.5 mm ABP procedure, resulting in aseptic loosening.

Conclusion: Due to the child’s underdeveloped posture, the surgeon utilized the 3.5 mm instrumentation for a child-size implant, which worked sufficiently for the surgery but may not have loosened if a similar child-size blade plate system of 4.5 mm screws was implanted. While the ABP and OP-LCP systems are effective and safe for internal corrections of PFOs, the OP-LCP system may aid the residents in learning the procedure with higher confidence, fewer technical inaccuracies, and refined outcomes. Both systems are safer and viable for the treatment of neuromuscular hip conditions.

Author Biography

Julieanne P. Sees, Nemours Alfred I. duPont Hospital for Children

Julieanne P. Sees, DO, FAOA, FAOAO, is an AOA board-certified osteopathic pediatric neuro-orthopedic surgeon at Nemours Alfred I. duPont Hospital for Children in Wilmington, Delaware, where she serves as medical director. She holds a dual fellowship trained in a pediatric orthopedic surgery fellowship and a neuro-orthopedic surgery fellowship at Nemours Alfred I. DuPont Hospital for Children.

An active member of the osteopathic medical profession, Dr. Sees serves on the AOA’s Council on Postdoctoral Training and the American Osteopathic Foundation (AOF) board of directors. Currently she is president of the Delaware State Osteopathic Medical Society. She has been honored as Emerging Leader of the Year by both AOF and the Chicago College of Osteopathic Medicine Alumni Association.

Dr. Sees received her degree in osteopathic medicine from Midwestern University Chicago College of Osteopathic Medicine in Downers Grove, Illinois. During medical school she received several honors, including the Illinois Medical Society Student of the Year Award and the National Medical Council of Student Government Presidents Student DO of the Year.

She completed a combined internship and orthopedic residency at the former University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine. She received AOF’s Outstanding Resident of the Year Award.

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Published
2021-04-21
How to Cite
Ahmed Nahian, & Julieanne P. Sees. (2021). 8-Year-Old Child with Cerebral Palsy Treated with Pelvic Osteotomies Using 3.5 mm Blade Plate Having Subsequent Bilateral Implant Aseptic Loosening: A Case Report. International Journal of Medical Students, 9(1), 52-55. https://doi.org/10.5195/ijms.2021.698
Section
Case Report