Introduction
Children with neurological conditions, like cerebral palsy, are at risk of hip displacement. Hip displacement is when the ball at the top of the thigh bone, also known as the femur, moves out of the hip socket.
Surgery can be done to the growth plate at the top end of the thigh bone to direct the growth of the ball towards the hip socket. The growth plate is where new bone is formed, allowing children’s arms and legs to grow in length. This procedure can help to delay or prevent further hip surgery for your child.
Before the procedure
Your child’s medical team will assist you and provide you with information on how to prepare your child for the procedure.
The physiotherapy team may also contact you to discuss your child’s recovery needs.
Before your child has the hip guided growth procedure, it is important to:
- contact your local physiotherapist or occupational therapist to make an appointment for after the procedure date
- talk to your child’s school about the procedure, letting them know they will need time off to recover and support to return to school safely
- arrange time off for yourself around the surgery date and let family and friends know so they can give you support if needed
- let the hospital know as soon as possible if your child becomes sick before their procedure date, as it may need to be postponed.
During the procedure
Your child will be under general anaesthesia for their procedure. This means they will be asleep.
During the procedure, the surgeon will insert a screw through the growth plate, into the ball of the thigh bone. This screw will stay in place for 2 years to direct the growth of the bone.
After the procedure
Your child will be given medication when they wake up to manage their pain from the procedure. Pain management in hospital is done by giving medicine through an intravenous drip or taking medicine by mouth.
There are no specific restrictions after surgery and your child should be able to return to their usual activities as soon as they feel comfortable and are not in pain.
Management
Caring for your child at home
Your child will be sent home with pain relief to help them recover comfortably. Follow the timing and instructions for pain relief carefully.
Your child may need special equipment to help with daily tasks such as showering and toileting. The occupational therapist will help you with this in hospital.
Recovery and movement at home
Your child should be able to stand on their leg and support their body weight straight away if they are comfortable and not in pain. This will depend on the preference of the surgeon and whether other surgeries have been performed at the same time.
Your child may need to be positioned with their legs apart after surgery. If your child needs positioning, they will be fitted with an appropriate positioning device like a foam wedge or a brace.
If your child wears an ankle foot orthosis (AFO), they should continue to wear this after surgery.
Your child’s physiotherapist will help them return to their usual physical function and mobility after the surgery.
Removal of the screw
The screw will stay in place for 1-2 years to help control the direction of bone growth. Your child’s surgeons will check the bone growth over this time by taking x-rays. The surgeon will decide when it is time for the screw to be removed based on how your child’s bone is growing.