{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:41:21Z","timestamp":1791438081115,"version":"4.3.3"},"reference-count":28,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"5","license":[{"start":{"date-parts":[[2014,5,1]],"date-time":"2014-05-01T00:00:00Z","timestamp":1398902400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:p> Proximal femoral resection (PFR) is a proven pain-relieving procedure for the management of patients with severe cerebral palsy and a painful displaced hip. Previous authors have recommended post-operative traction or immobilisation to prevent a recurrence of pain due to proximal migration of the femoral stump. We present a series of 79 PFRs in 63 patients, age 14.7 years (10 to 26; 35 male, 28 female), none of whom had post-operative traction or immobilisation. <\/jats:p><jats:p> A total of 71 hips (89.6%) were reported to be pain free or to have mild pain following surgery. Four children underwent further resection for persistent pain; of these, three had successful resolution of pain and one had no benefit. A total of 16 hips (20.2%) showed radiographic evidence of heterotopic ossification, all of which had formed within one year of surgery. Four patients had a wound infection, one of which needed debridement; all recovered fully. A total of 59 patients (94%) reported improvements in seating and hygiene. <\/jats:p><jats:p> The results are as good as or better than the historical results of using traction or immobilisation. We recommend that following PFR, children can be managed without traction or immobilisation, and can be discharged earlier and with fewer complications. However, care should be taken with severely dystonic patients, in whom more extensive femoral resection should be considered in combination with management of the increased tone. <\/jats:p><jats:p> Cite this article: Bone Joint J 2014; 96-B:701\u20136. <\/jats:p>","DOI":"10.1302\/0301-620x.96b5.32963","type":"journal-article","created":{"date-parts":[[2014,5,1]],"date-time":"2014-05-01T15:08:48Z","timestamp":1398956928000},"page":"701-706","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Proximal femoral resection without post-operative traction for the painful dislocated hip in young patients with cerebral palsy"],"prefix":"10.1302","volume":"96-B","author":[{"given":"J.","family":"Dartnell","sequence":"first","affiliation":[{"name":"Evelina London Children\u2019s Hospital, Guy\u2019s\rand St Thomas\u2019 Hospital, Westminster Bridge\rRoad, London, SE1 7EH, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Gough","sequence":"additional","affiliation":[{"name":"Evelina London Children\u2019s Hospital, Guy\u2019s\rand St Thomas\u2019 Hospital, Westminster Bridge\rRoad, London, SE1 7EH, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M. H.","family":"Paterson","sequence":"additional","affiliation":[{"name":"The Royal London Hospital, Whitechapel\rRoad, London E1\u00a01BB, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Norman-Taylor","sequence":"additional","affiliation":[{"name":"Evelina London Children\u2019s Hospital, Guy\u2019s\rand St Thomas\u2019 Hospital, Westminster Bridge\rRoad, London, SE1 7EH, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"r1","unstructured":"No authors listed. Cerebral Palsy Alliance. https:\/\/www.cerebralpalsy.org.au\/what-is-cerebral-palsy\/types-of-cerebral-palsy\/gross-motor-function-classification-system\/ (date last accessed 19 March 2014)."},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199911000-00020"},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B8.21808"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197860080-00005"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197254040-00017"},{"key":"r6","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0b013e3282f05cd8"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.1080\/17453670902804935"},{"key":"r8","first-page":"70","volume":"25","author":"Leet AI","year":"2005","journal-title":"J Pediatr Orthop"},{"key":"r9","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e31818e8569"},{"key":"r10","first-page":"1011","volume":"70","author":"McCarthy RE","year":"1988","journal-title":"[Am]"},{"key":"r11","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198611000-00007"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.3109\/ort.1980.51.suppl-184.01"},{"key":"r13","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2012.36.1.33"},{"key":"r14","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000146"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2003.tb00937.x"},{"key":"r16","first-page":"61","volume":"22","author":"Albi\u00f1ana J","year":"2002","journal-title":"Iowa Orthop J"},{"key":"r17","doi-asserted-by":"crossref","unstructured":"Yankeum J, Bourelle S, Lefort G, et al. 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