Combined Femoral and Pelvic Osteotomies Versus Femoral Osteotomy Alone in the Treatment of Hip Dysplasia in Children With Cerebral Palsy
Bibliographic record
Abstract
PURPOSE: Although evidence is increasing that the most effective treatment for the severely subluxated or dislocated hips is a one-stage comprehensive approach there are few studies that compare the results with the traditional approach (varus derotational osteotomy, VDRO). The purpose of this study is to evaluate the clinical and radiologic outcome after one-stage reconstruction versus VDRO alone. METHODS: We retrospectively analyzed 52 hips in 39 consecutive patients with spastic cerebral palsy treated from January 1997 to January 2007. Group A (36 hips) was treated with a VDRO and San Diego osteotomy and group B (16 hips) with VDRO alone. Mean age was 8.1+/-3.6 years. Mean follow-up was 4.4 years. Evaluation was performed according to clinical criteria (hip range of motion, pain, and sitting comfort) and radiographic parameters [center-edge angle, acetabular index, neckshaft angle, and Reimer's Index (MI)]. RESULTS: There were no delayed unions, avascular necrosis of the femoral head, or postoperative infections in either group. There was significant decrease in pain and improvement of the center-edge angle and acetabular index in the combined approach. Of the patients who had VDRO alone 25% needed revision procedures and none of the combined group needed other procedures. CONCLUSIONS: The clinical and radiologic results obtained by the one-stage procedure were far better than doing VDRO alone justifying a more extensive approach. Consideration should be given to performing the combined procedure in cerebral palsy patients with hip subluxation or dislocation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".