Tuesday, August 1, 2017

Common complications of hip procedures in children with cerebral palsy

In the last post, we discussed the different surgical procedures that are typically performed for the treatment of hip disorders in children with cerebral palsy. Parents are always concerned  about the complications associated with these procedures. I will discuss the common complications of these procedures in this post

1- Bleeding requiring blood transfusion: Like any other surgery, hip surgery in children with cerebral palsy can result in blood loss requiring blood transfusion.The risk of this complication is highest in young children undergoing procedures involving reshaping of the pelvis. The risk of blood loss requiring blood transfusion is typically less than 10%. The children on seizure medications may loose more blood during surgery due to the effect of seizure medications on blood.

2-Wound infection: With the current universal use of antibiotics before surgery, wound infection is not a common complication and can typically be treated with antibiotics by mouth. Children with a history of prior MRSA infection, may benefit from receiving a different type of antibiotics prior to surgery. Please mention the history of infection to your physician before surgery.

3- Recurrence: After reconstruction, unfortunately hips may still dislocate in children with cerebral palsy due to the continued spasticity. This risk is highest in children with higher levels of involvement (GMFCS V). The recurrence can be seen in up to 30% of the patients depending on the type of the procedure performed and the level of spasticity. It is very important that hips continue to be monitored with radiographs after surgery until skeletal maturity.

These include the common complications seen after hip reconstructive procedures in children with spastic cerebral palsy.