Effects of early weight bearing on the functional recovery of ambulatory children with cerebral palsy after bilateral proximal femoral osteotomy.

This study evaluates the effects of early versus delayed weight bearing on the functional recovery of ambulatory children with cerebral palsy (CP) after they have undergone proximal femoral osteotomies (PFOs). We retrospectively reviewed the cases of 25 ambulatory children with CP who underwent PFO to correct excessive hip internal rotation and intoeing. Thirteen children were permitted to weight-bear as tolerated (WBAT) immediately after surgery, and 12 were placed on non-weight bearing restrictions for 3 to 7 weeks (mean +/- SD, 30 +/- 6.7 days). There were no major complications. The children in the WBAT group initiated standing 26 days sooner and returned to baseline walking almost 4 months sooner than those on non-weight bearing restrictions. Pain at 8 days postoperatively was significantly less for the WBAT group, but pain at the time of initial standing and walking was not significantly different between groups. In conclusion, early mobilization after PFOs in children with CP is safe, with reduced recovery time, and with decreased pain.