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adductor releases.
65%
381/586
adductor releases and psoas lengthenings.
20%
116/586
varus derotational osteotomies.
5%
29/586
pelvic osteotomies.
3%
19/586
varus derotational osteotomies with pelvic osteotomies.
6%
36/586
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One of the few indications for surgical treatment in children with cerebral palsy who are younger than 4 years of age is soft-tissue release of the hip in children with limited abduction. If hip abduction is limited, then radiographs of the hips are indicated to look for hip subluxation or dislocation. If there are no significant bony changes, then soft-tissue release or lengthenings are indicated. Psoas lengthening is indicated if there is evidence of a hip flexion contracture (ie, positive Thomas test), which is not present in this patient. If there is evidence of significant hip subluxation and osseous dysplasia, a proximal femoral and/or pelvic osteotomy may be indicated. The latter is more common in older children.
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