Surgery for unstable hips in cerebral palsy.

We studied 67 patients with 86 unstable hips, all of whom had total-body-involvement cerebral palsy. Sixty-four operations were performed on 53 hips in 39 patients in a sequential radiographically controlled manner. Twenty-five operations were contralateral operations on a previously treated patient or revisions of a previous procedure. Soft-tissue release alone led to recurrence of dislocation or subluxation in many patients and has been abandoned. Combined pelvic and femoral osteotomy and soft-tissue release corrected the migration percentage and center-edge angle better than femoral osteotomy and soft-tissue release alone. Excision of the proximal femur was a useful salvage procedure if the femoral head was eroded.