ArticleJournal of the Pediatric Orthopaedic Society of North America2026
Proximal Femur Guided Growth for Hip Displacement in Hypotonic Cerebral Palsy: A Preliminary Report.
Article in Journal of the Pediatric Orthopaedic Society of North America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Proximal femur guided growth (PFGG) is a minimally invasive treatment option for coxa valga and hip displacement in cerebral palsy (CP). Its role in hypotonic CP remains unclear. This study evaluated PFGG as a potential intermediate surgical option between observation and reconstructive osteotomy for hypotonic hip coverage deficiency. Methods: This retrospective study reviewed children with hypotonic CP who received PFGG for hip acetabular coverage deficiency from 2012 to 2021. Surgical indications included a head-shaft angle (HSA) greater than 155° and a Reimers' migration percentage (MP) greater than 30%. The MP, HSA, and acetabular index were measured on serial radiographs. A decrease or increase in MP by 5 percentage points or more postoperatively was considered clinically significant. Adverse events, revision PFGG, and reconstructive procedures were recorded. Results: Fourteen patients (25 hips) underwent PFGG without concomitant soft-tissue releases at a mean age of 5.3 years (standard deviation: 2.3). The HSA improved significantly from 175.7° preoperatively to 165.3° at 2 years and 163.0° at the latest follow-up (mean: 50.4 months; Conclusions: PFGG significantly decreased coxa valga but did not reliably affect MP or acetabular coverage. While it may provide a low-morbidity, intermediate surgical treatment option for selected hypotonic CP hips with coxa valga, further research is warranted to assess its clinical effectiveness. Key Concepts: (1)Proximal femur guided growth demonstrated a limited effect on reducing hip displacement in hypotonic cerebral palsy despite coxa valga improvement.(2)Guided growth may offer a more active treatment option than observation alone.(3)Early application of proximal femur guided growth is recommended for hips with a migration percentage <40% to prevent progression of hypotonic hip displacement. Level of Evidence: Level IV, case series study.
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