Neuromuscular Disorders: Treatment Complications of Bone Procedures in Neurological Disorders (Included Foot)

Ahmet SEVENCANa , Ali ŞEKERb

aUniversity of Health Sciences Metin Sabancı Baltalimanı Bone Diseases Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Türkiye
bİstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Orthopedics and Traumatology, İstanbul, Türkiye

ABSTRACT
Children with neuromuscular disorders may develop contractures, extremity deformities, hip dislocations or scoliosis. Rigid contractures, hip dislocations or problems in elder children may require bone procedures. Derotation osteotomies, hip reduction and reconstructions, distal femur extension osteotomies, arthrodeses are most common bone procedures. Several complications were reported related with these surgeries. Delayed union/nonunion, malunion, infection, neurovascular injuries, implant failure, redislocation after hip reconstruction, relaps of the contractures/deformities can be seen. Unfortunately, management of these complications may need revision surgeries.
Keywords: Cerebral palsy; complications; osteotomy; arthrodesis

Referanslar

  1. Soo B, Howard JJ, Boyd RN, Reid SM, Lanigan A, Wolfe R, et al. Hip displacement in cerebral palsy. J Bone Joint Surg Am. 2006;88(1):121-9. [Crossref]  [PubMed]
  2. Hägglund G, Lauge-Pedersen H, Wagner P. Characteristics of children with hip displacement in cerebral palsy. BMC Musculoskelet Disord. 2007;8:101. [Crossref]  [PubMed]  [PMC]
  3. Shore BJ, Zurakowski D, Dufreny C, Powell D, Matheney TH, Snyder BD. Proximal Femoral Varus Derotation Osteotomy in Children with Cerebral Palsy: The Effect of Age, Gross Motor Function Classification System Level, and Surgeon Volume on Surgical Success. J Bone Joint Surg Am. 2015;97(24):2024-31. [Crossref]  [PubMed]
  4. Inan M, Senaran H, Domzalski M, Littleton A, Dabney K, Miller F. Unilateral versus bilateral peri-ilial pelvic osteotomies combined with proximal femoral osteotomies in children with cerebral palsy: perioperative complications. J Pediatr Orthop. 2006;26(4):547-50. [Crossref]  [PubMed]
  5. Tzatzairis T, McMahon S, Shilpa J, Maizen C. Safety and efficacy of tranexamic acid in children with cerebral palsy undergoing femoral varus derotational osteotomy: a double cohort study. Eur J Orthop Surg Traumatol. 2020;30(6):1039-44. [Crossref]  [PubMed]
  6. Song HR, Carroll NC. Femoral varus derotation osteotomy with or without acetabuloplasty for unstable hips in cerebral palsy. J Pediatr Orthop. 1998;18(1):62-8. [Crossref]
  7. Chang FM, May A, Faulk LW, Flynn K, Miller NH, Rhodes JT, et al. Outcomes of Isolated Varus Derotational Osteotomy in Children With Cerebral Palsy Hip Dysplasia and Predictors of Resubluxation. J Pediatr Orthop. 2018;38(5):274-8. [Crossref]  [PubMed]
  8. Wagner P, Hägglund G. Hip development after surgery to prevent hip dislocation in cerebral palsy: a longitudinal register study of 252 children. Acta Orthop. 2022;93:45-50. [Crossref]  [PubMed]  [PMC]
  9. Khalife R, Ghanem I, El Hage S, Dagher F, Kharrat K. Risk of recurrent dislocation and avascular necrosis after proximal femoral varus osteotomy in children with cerebral palsy. J Pediatr Orthop B. 2010;19(1):32-7. [Crossref]  [PubMed]
  10. Phillips L, Hesketh K, Schaeffer EK, Andrade J, Farr J, Mulpuri K. Avascular necrosis in children with cerebral palsy after reconstructive hip surgery. J Child Orthop. 2017;11(5):326-33. [Crossref]  [PubMed]  [PMC]
  11. Koch A, Jozwiak M, Idzior M, Molinska-Glura M, Szulc A. Avascular necrosis as a complication of the treatment of dislocation of the hip in children with cerebral palsy. Bone Joint J. 2015;97-B(2):270-6. [Crossref]  [PubMed]
  12. Miller F. Hip Reconstruction in Children with Cerebral Palsy. In: Miller F, Bachrach S, Lennon N, O'Neil ME, eds. Cerebral Palsy. 2nd ed. Switzerland: Springer Nature; 2020. p.1930-48. [Crossref]
  13. Beauchesne R, Miller F, Moseley C. Proximal femoral osteotomy using the AO fixed-angle blade plate. J Pediatr Orthop. 1992;12(6):735-40. [Crossref]  [PubMed]
  14. Vallim FCM, Nogueira-Barbosa MH, da Cruz HA, Viana VM, Ferzeli MV, Guimarães JAM. Conventional versus locked plates for hip dislocation in cerebral palsy: a matched cohort analysis. Eur J Orthop Surg Traumatol. 2023;33(8):3429-34. [Crossref]  [PubMed]
  15. Krum SD, Miller F. Heterotopic ossification after hip and spine surgery in children with cerebral palsy. J Pediatr Orthop. 1993;13(6):739-43. [Crossref]  [PubMed]
  16. Botte MJ, Keenan MA, Abrams RA, von Schroeder HP, Gellman H, Mooney V. Heterotopic ossification in neuromuscular disorders. Orthopedics. 1997;20(4):335-41; quiz 342-3. [Crossref]  [PubMed]
  17. Szalay EA, Harriman D, Eastlund B, Mercer D. Quantifying postoperative bone loss in children. J Pediatr Orthop. 2008;28(3):320-3. [Crossref]  [PubMed]
  18. Islam SU, Henry A, Khan T, Davis N, Zenios M. The outcome of paediatric LCP hip plate use in children with and without neuromuscular disease. Musculoskelet Surg. 2014;98(3):233-9. [Crossref]  [PubMed]
  19. Stout JL, Gage JR, Schwartz MH, Novacheck TF. Distal femoral extension osteotomy and patellar tendon advancement to treat persistent crouch gait in cerebral palsy. J Bone Joint Surg Am. 2008;90(11):2470-84. [Crossref]  [PubMed]
  20. Rutz E, Gaston MS, Camathias C, Brunner R. Distal femoral osteotomy using the LCP pediatric condylar 90-degree plate in patients with neuromuscular disorders. J Pediatr Orthop. 2012;32(3):295-300. [Crossref]  [PubMed]
  21. İnan M, Sarikaya İA, Yildirim E, Güven MF. Neurological complications after supracondylar femoral osteotomy in cerebral palsy. J Pediatr Orthop. 2015;35(3):290-5. [Crossref]  [PubMed]
  22. Asirvatham R, Mukherjee A, Agarwal S, Rooney RJ, Ellis RD, Watts HG. Supracondylar femoral extension osteotomy: its complications. J Pediatr Orthop. 1993;13(5):642-5. [Crossref]  [PubMed]
  23. Zimmerman MH, Smith CF, Oppenheim WL. Supracondylar femoral extension osteotomies in the treatment of fixed flexion deformity of the knee. Clin Orthop Relat Res. 1982;(171):87-93. [Crossref]
  24. Klotz MCM, Hirsch K, Heitzmann D, Maier MW, Hagmann S, Dreher T. Distal femoral extension and shortening osteotomy as a part of multilevel surgery in children with cerebral palsy. World J Pediatr. 2017;13(4):353-9. [Crossref]  [PubMed]
  25. Healy MT, Schwartz MH, Stout JL, Gage JR, Novacheck TF. Is simultaneous hamstring lengthening necessary when performing distal femoral extension osteotomy and patellar tendon advancement? Gait Posture. 2011;33(1):1-5. [Crossref]  [PubMed]
  26. Böhm H, Hösl M, Döderlein L. Predictors for anterior pelvic tilt following surgical correction of flexed knee gait including patellar tendon shortening in children with cerebral palsy. Gait Posture. 2017;54:8-14. [Crossref]  [PubMed]
  27. de Morais Filho MC, Blumetti FC, Kawamura CM, Leite JBR, Lopes JAF, Fujino MH, et al. The increase of anterior pelvic tilt after crouch gait treatment in patients with cerebral palsy. Gait Posture. 2018;63:165-70. [Crossref]  [PubMed]
  28. Liou YL, Lee WC, Kao HK, Yang WE, Chang CH. Genu Valgum After Distal Femur Extension Osteotomy in Children With Cerebral Palsy. J Pediatr Orthop. 2022;42(4):e384-e9. [Crossref]  [PubMed]
  29. Er MS, Abousamra O, Rogers KJ, Bayhan IA, Church C, Henley J, et al. Long-term Outcome of Internal Tibial Derotation Osteotomies in Children With Cerebral Palsy. J Pediatr Orthop. 2017;37(7):454-9. [Crossref]  [PubMed]
  30. Krengel WF 3rd, Staheli LT. Tibial rotational osteotomy for idiopathic torsion. A comparison of the proximal and distal osteotomy levels. Clin Orthop Relat Res. 1992;(283):285-9. [Crossref]
  31. Staheli LT. Torsion--treatment indications. Clin Orthop Relat Res. 1989;(247):61-6. [Crossref]
  32. Ryan DD, Rethlefsen SA, Skaggs DL, Kay RM. Results of tibial rotational osteotomy without concomitant fibular osteotomy in children with cerebral palsy. J Pediatr Orthop. 2005;25(1):84-8. [Crossref]  [PubMed]
  33. Schrock RD Jr. Peroneal nerve palsy following derotation osteotomies for tibial torsion. Clin Orthop Relat Res. 1969;62:172-7. [Crossref]  [PubMed]
  34. Curley P, Eyres K, Brezinova V, Allen M, Chan R, Barnes M. Common peroneal nerve dysfunction after high tibial osteotomy. J Bone Joint Surg Br. 1990;72(3):405-8. [Crossref]  [PubMed]
  35. Thompson RM, Ihnow S, Dias L, Swaroop V. Tibial derotational osteotomies in two neuromuscular populations: comparing cerebral palsy with myelomeningocele. J Child Orthop. 2017;11(4):243-8. [Crossref]  [PubMed]  [PMC]
  36. Davids JR. The foot and ankle in cerebral palsy. Orthop Clin North Am. 2010;41(4):579-93. [Crossref]  [PubMed]
  37. Miller F. Foot Deformities in Children with Cerebral Palsy: An Overview. In: Miller F, Bachrach S, Lennon N, O'Neil ME, eds. Cerebral Palsy. 2nd ed. Switzerland: Springer Nature; 2212. p.23.
  38. Sees JP, Miller F. Overview of foot deformity management in children with cerebral palsy. J Child Orthop. 2013;7(5):373-7. [Crossref]  [PubMed]  [PMC]
  39. Kadhim M, Miller F. Pes planovalgus deformity in children with cerebral palsy: review article. J Pediatr Orthop B. 2014;23(5):400-5. [Crossref]  [PubMed]
  40. Ozkan T, Tuncer S. Upper Extremity Surgery in Spastic Cerebral Palsy. JAREM. 2012;2:43-54. [Crossref]
  41. Miller F. Upper extremity operative procedures in cerebral palsy. In: Miller F, Bachrach S, Lennon N, O'Neil ME, eds. Cerebral Palsy. 2nd ed. Switzerland: Springer Nature; 2020. p.1670-97. [Crossref]
  42. Ty Jennifer, Miller F. Forearm, Thumb, and Finger Deformities in Cerebral Palsy. In: Miller F, Bachrach S, Lennon N, O'Neil ME, eds. Cerebral Palsy. 2nd ed. Switzerland: Springer Nature; 2020. p.1644-69. [Crossref]
  43. Llusa-Pérez M, Morro-Martí MR, Pacha-Vicente D, Nardi-Vilardaga J, Lluch-Bergadà A, Mir-Bullò X. Wrist arthrodesis in neurological patients. Orthop Procs. 2011;93-B(SUPP_II):138-38.
  44. Neuhaus V, Kadzielski JJ, Mudgal CS. The role of arthrodesis of the wrist in spastic disorders. J Hand Surg Eur Vol. 2015;40(5):512-7. [Crossref]  [PubMed]
  45. Jimenez A, Anand P. Wrist Arthrodesis. [Updated 2023 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: [Link]
  46. Herring JA. Poliomyelitis. In: Herring JA, ed.Tachdjian's Pediatric Orthopaedics. 6th ed. Philadelphia: Elsevier; 2022. p.1582-679.
  47. Oishi S, Stutz C, Lake A. Disorders of Upper Extremity. In: Herring JA editor. Tachdjian's Pediatric Orthopaedics. 6th ed. Philadelphia: Elsevier; 2022. p.300-421.
  48. Deng X, Wu L, Yang C, Xu Y. Neuropathic arthropathy caused by syringomyelia. J Neurosurg Spine. 2013;18(3):303-9. [Crossref]  [PubMed]
  49. Jen CL, Tan JC. Neuropathic arthropathy of the elbow treated with double-plate arthrodesis and resection site bone graft. Shoulder Elbow. 2016;8(1):48-53. [Crossref]  [PubMed]  [PMC]
  50. Kamineni S, Matthew EE, Desai R. Elbow Arthrodesis-A Review. Shoulder Elbow. 2019;3:1-7. [Crossref]
  51. Miller F. Shoulder and Elbow Problems in Cerebral Palsy. In: Miller F, Bachrach S, Lennon N, O'Neil ME, eds. Cerebral Palsy. 2nd ed. Switzerland: Springer Nature; 2020. p.1630-43. [Crossref]
  52. Abzug JM, Chafetz RS, Gaughan JP, Ashworth S, Kozin SH. Shoulder function after medial approach and derotational humeral osteotomy in patients with brachial plexus birth palsy. J Pediatr Orthop. 2010;30(5):469-74. [Crossref]  [PubMed]
  53. Abboud JA, Cronin KJ. Shoulder Arthrodesis. J Am Acad Orthop Surg. 2022;30(16):e1066-e75. [Crossref]  [PubMed]