{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:47:31Z","timestamp":1785833251752,"version":"3.56.0"},"reference-count":21,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Hip displacement is a common and progressive musculoskeletal complication in children with cerebral palsy (CP), often driven by coxa valga, muscle imbalance, and spasticity. While proximal femoral and pelvic osteotomies remain the standard treatment for advanced deformity, proximal femoral guided growth (temporary medial hemiepiphysiodesis) has emerged as a minimally invasive alternative for selected patients with remaining growth potential. This narrative review summarizes the current evidence regarding indications, surgical technique, radiographic outcomes, complications, and future directions for proximal femoral guided growth in CP. The literature, consisting primarily of retrospective case series and one systematic review, consistently demonstrates improvements in migration percentage, head\u2013shaft angle, and acetabular index, particularly when treatment is performed early in children with migration percentages below 50% and combined with soft tissue release. Younger age and less severe hip displacement are associated with more favorable outcomes. The most common complication is screw migration as the physis grows off the implant, frequently necessitating revision, although serious complications are uncommon. Concerns remain regarding premature physeal closure and potential femoral head deformity at skeletal maturity. Current evidence supports proximal femoral guided growth as a valuable intermediate treatment that may delay or reduce the need for reconstructive osteotomy in appropriately selected patients; however, high-quality prospective studies are needed to define better its long-term safety, efficacy, and optimal role in treatment algorithms.<\/jats:p>","DOI":"10.3390\/jcm15156057","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:02:19Z","timestamp":1785830539000},"page":"6057","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Evolution of Proximal Femur Hemiepiphysiodesis in Children with Cerebral Palsy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6880-3662","authenticated-orcid":false,"given":"Trevor","family":"Blanchard","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH 45229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH 45229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5092-7256","authenticated-orcid":false,"given":"Verena M.","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH 45229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref_1","first-page":"121","article-title":"Hip displacement in cerebral palsy","volume":"88","author":"Soo","year":"2006","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3675","DOI":"10.1007\/s11999-015-4515-3","article-title":"Determinants of Hip Displacement in Children with Cerebral Palsy","volume":"473","author":"Chang","year":"2015","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"277","DOI":"10.5535\/arm.2018.42.2.277","article-title":"Determinants of Hip and Femoral Deformities in Children with Spastic Cerebral Palsy","volume":"42","author":"Cho","year":"2018","journal-title":"Ann. Rehabil. Med."},{"key":"ref_4","unstructured":"Miller, F. (2005). Cerebral Palsy, Springer."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.2214\/ajr.146.6.1219","article-title":"Hip changes in spastic cerebral palsy","volume":"146","author":"Sauser","year":"1986","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"198","DOI":"10.5435\/00124635-200205000-00006","article-title":"Management of hip disorders in patients with cerebral palsy","volume":"10","author":"Flynn","year":"2002","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1051\/sicotj\/2024023","article-title":"Hip displacement in children with cerebral palsy: Surveillance to surgery\u2014A current concepts review","volume":"10","author":"Howard","year":"2024","journal-title":"SICOT J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e622","DOI":"10.1097\/BPO.0000000000001069","article-title":"Guided Growth of the Proximal Femur for the Management of Hip Dysplasia in Children with Cerebral Palsy","volume":"39","author":"Portinaro","year":"2019","journal-title":"J. Pediatr. Orthop."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/01202412-200607000-00014","article-title":"Progressive coxa vara by eccentric growth tethering in immature pigs","volume":"15","author":"Chang","year":"2006","journal-title":"J. Pediatr. Orthop. B"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1097\/BPO.0b013e3181edef71","article-title":"Guided growth of the proximal femur: A pilot study in the lamb model","volume":"30","author":"McCarthy","year":"2010","journal-title":"J. Pediatr. Orthop."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/BPO.0000000000000771","article-title":"Proximal Femoral Growth Modification: Effect of Screw, Plate, and Drill on Asymmetric Growth of the Hip","volume":"38","author":"McCarthy","year":"2018","journal-title":"J. Pediatr. Orthop."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2568","DOI":"10.1097\/CORR.0000000000000903","article-title":"Guided Growth Improves Coxa Valga and Hip Subluxation in Children with Cerebral Palsy","volume":"477","author":"Hsieh","year":"2019","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1097\/BPO.0000000000000480","article-title":"Guided Growth of the Proximal Femur for Hip Displacement in Children with Cerebral Palsy","volume":"36","author":"Lee","year":"2016","journal-title":"J. Pediatr. Orthop."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1302\/0301-620X.102B9.BJJ-2020-0340.R1","article-title":"Does screw position matter for guided growth in cerebral palsy hips?","volume":"102","author":"Hsu","year":"2020","journal-title":"Bone Jt. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"245","DOI":"10.55275\/JPOSNA-2021-245","article-title":"Proximal Femur Guided Growth for the Management of Hip Dysplasia in Children with Cerebral Palsy","volume":"3","author":"Davids","year":"2021","journal-title":"J. Pediatr. Orthop. Soc. N. Am."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Lebe, M., van Stralen, R.A., and Buddhdev, P. (2022). Guided Growth of the Proximal Femur for the Management of the \u2019Hip at Risk\u2019 in Children with Cerebral Palsy-A Systematic Review. Children, 9.","DOI":"10.3390\/children9050609"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e583","DOI":"10.1097\/BPO.0000000000002152","article-title":"Proximal Femoral Screw Hemiepiphysiodesis in Children with Cerebral Palsy Improves the Radiographic Measures of Hip Subluxation","volume":"42","author":"Zakrzewski","year":"2022","journal-title":"J. Pediatr. Orthop."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e389","DOI":"10.1097\/BPO.0000000000003186","article-title":"The Effects of Age and Migration Severity on Surgical Success After Guided Growth for Hip Displacement in Cerebral Palsy: A Preliminary Report","volume":"46","author":"Herrero","year":"2026","journal-title":"J. Pediatr. Orthop."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/BPO.0000000000002964","article-title":"Outcome and Femoral Head Deformity Following Hip Guided Growth in Children with Cerebral Palsy at Skeletal Maturity","volume":"45","author":"Chiu","year":"2025","journal-title":"J. Pediatr. Orthop."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/j.jos.2021.06.019","article-title":"The effectiveness of adding guided growth to soft tissue release in treating spastic hip displacement","volume":"27","author":"Sheu","year":"2022","journal-title":"J. Orthop. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e091073","DOI":"10.1136\/bmjopen-2024-091073","article-title":"GUIDANCE study: Guided growth of the proximal femur to prevent further hip migration in patients with cerebral palsy-study protocol for a multicentre randomised controlled trial","volume":"14","author":"Roelen","year":"2024","journal-title":"BMJ Open"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6057\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:38:00Z","timestamp":1785832680000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6057"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":21,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15156057"],"URL":"https:\/\/doi.org\/10.3390\/jcm15156057","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]}}}