Surgical treatment of bilateral hip dislocation in children with arthrogryposis multiplex congenita

• DOI: 10.3760/cma.j.issn.0253-3006.2015.06.014
• Publication Date: 2015-06-15
• Authors: Chaosu Hu; Xu Li; Weiping Wu; Shuangwu Dai; Wei Tan; Qiang Shi
• Keywords: Arthrogryposis multiplex congenita; Avascular Necrosis

Objective To explore the surgical strategies of bilateral hip dislocation in children with arthrogryposis multiplex congenita.

Methods Retrospective analyses were conducted for clinical data 8 congenita from July 2008 to 2012. There 5 males and 3 females an average age 16 (5-39) months. They underwent open reduction by S-P incision medial approach along pelvic osteotomy, femoral osteotomy.

Results The follow-up period was 3.5 (2-5.2) years. The gaits relatively normal (n=2), slightly limping (n=1) unbalanced (n=2). One case required wearing a long leg orthosis walking 2 cases relied upon wheelchair. And ranges motion (ROM) (4 hips), limited hips) significantly hips). According radiological Severin evaluation criteria modified McKay scheme, outcomes excellent good (8 fair Postoperative ROM improved 30 versus preoperative one. left 70.4°±6.3°, postoperative 104.1°±9.6°; right 72.0°±10.2°, 102.5°±8.9°. significant differences existed between ROMs (P<0.001). However, hips had avascular necrosis head. grades Kalamchi & MacEwen Ⅰ(n=1), Ⅲ Ⅵ(n=1) respectively.

Conclusions For congenital, should be managed restoring anatomic structure joint. anterior plus pelvic-femoral osteotomy is effective these patients.

Key words: Joints; Contracture; Hip dislocation; Osteotomy