Irreducible dislocation of the hip in cerebral palsy patients treated by Schanz proximal femoral valgus osteotomy

Palliative Schanz proximal femoral valgus osteotomy is considered a common option for treatment of irreducible hip dislocation in cerebral palsy. From 1992 to 2005, Schanz osteotomy was indicated on 55 occasions in 35 nonambulatory patients with the quadriplegic form of cerebral palsy aged 9–18. Postoperatively, the main emphasis focussed on clinical presentation, improvement of hip range of motion, and pain relief. X-rays were carried out at three, six, and 12 months postoperatively with subsequent average follow up 98 ± 4.5 months. In all patients, the range of hip abduction and flexion increased. In 54 (98.2%) cases painful symptoms significantly improved. One patient (1.8%) had a subsequent femoral head excision because of persistent hip pain. Transient hip pain persisted in four patients (7.3%). Schanz valgus osteotomy improves the hip range of motion, relieves pain, and facilitates care of the patient. Schanz femoral osteotomy is a less invasive method compared to proximal femoral excision and should preferably be used in older children with neurogenic hip dislocation in whom reconstructive surgery is not indicated

Resistance exercise training during pregnancy and newborn's birth size: a randomised controlled trial

Objective: Design: Subjects: Results: Conclusion: We examined the effect of light intensity resistance exercise training performed during the second and third trimester of pregnancy on the newborn's birth size. We also studied the association between maternal body weight prior to pregnancy and newborn's birth size.Randomised controlled trial.We randomly assigned 160 sedentary gravidae to either a training (n=80) or a control (n=80) group. The training programme focused on light resistance and toning exercises (three times per week, 35-40 min per session). We recorded the Apgar score, birth weight, birth length, and head circumference of the newborn, as well as gestational age at time of delivery from hospital perinatal records. We also measured maternal weight and height before parity and gestational weight gain.Maternal characteristics neither differed between groups (all P>0.1) nor newborn characteristics (all P>0.1). Maternal body weight was positively and significantly associated with newborn's birth weight and length only in the control group (beta=19.20 and 0.065, respectively, P<0.01).Light intensity resistance training performed over the second and third trimester of pregnancy does not have a negative impact on the newborn's body size or overall health. Exercise interventions might attenuate the adverse consequences of maternal body weight before pregnancy on the newborn's birth size.4.343 JCR (2009) Q1, 23/105 Endocrinology & metabolism, 4/66 Nutrition & dieteticsUE