Periacetabular Osteotomy — Chiari Pelvic Osteotomy (Pediatric Neurological Impairment)

Children's Colorado / Center for Gait and Movement Analysis (CGMA) · CGMA Physical Therapy Team, Children's Colorado

Weight-Bearing

NWB x 3-6 weeks in hip spica cast; slow progressive WB after cast removal per MD with good active LE control; WB based on bony integrity/bone density/x-ray

Key Restrictions

NWB 3-6 weeks; WB initiation based on bony healing/bone density/x-ray per MD; spasticity complications on cast removal; bivalved cast for transition; osteopenic precautions; minimize fall risk

Timeline & Phases

Phase 1 (days 1-7): splinting/positioning/assistive device needs, mobility/transfer training, pain management (cold/heat/massage/modalities), balance for transfers; Phase 2 (days 8-21): pain management, safe mobility; Phase 3 (day 22+): avoid impact/torque, full AROM with active LE control, return to pre-op mobility, functional balance, total LE endurance/strengthening (abdominals/glutes/calves), bracing assessment, scar mobility

Notes

Pediatric (neurological impairment/cerebral palsy); indication is hip subluxation/dislocation with acetabular dysplasia; periarticular pelvic osteotomy above acetabulum with entire acetabulum shifted medially and fixed with hardware; healing 6-8 weeks; Children's Colorado CGMA

Surgeon / Author

CGMA Physical Therapy Team, Children's Colorado

Published

October 2007