Which of the following is an acetabular or femoral osteotomy used in CP?

• A. Hemi-epiphysiodesis
• B. Acetabular/femoral osteotomies
• C. Botulinum toxin injections
• D. Oral baclofen

Answer: (B)

Osteotomies involve cutting and realigning bone to improve joint mechanics. In cerebral palsy, hip instability or dislocation often arises from poor femoral head coverage and abnormal acetabular orientation due to muscle imbalances and growth patterns. An acetabular osteotomy repositions the acetabulum to better cover the femoral head, while a femoral osteotomy changes the femur’s alignment or version to improve containment of the head within the socket. These reconstructive bone procedures are commonly used to stabilize the hip in CP when conservative treatments aren’t enough and when there’s malalignment contributing to subluxation or dislocation.

Hemi-epiphysiodesis, by contrast, is a growth-modulation procedure aimed at correcting angular deformities rather than directly addressing hip joint alignment. Botulinum toxin injections and oral baclofen target spasticity rather than bone alignment, so they don’t achieve the same hip joint realignment goals as osteotomies.