Stabilisation of the hip in myelomeningocele. Comparison of posterior iliopsoas transfer and varus-rotation osteotomy.
Patients with myelomeningocele who had had surgery to stabilise the hip were reviewed; the results of the 106 operations in 88 patients were assessed. In the earlier part of the series there were 55 children who had 64 iliopsoas transfers; later in the series 33 children had 42 varus-rotation osteotomies combined with adductor tenotomy, anterior obturator neurectomy and psoas division. The technical results of both operations were satisfactory: following iliopsoas transfer only 19% of the hips were either dislocated or subluxated; the corresponding figure for the osteotomy was 12%. Thus varus-rotation osteotomy with psoas division, adductor tenotomy and anterior obturator neurectomy was at least as effective in stabilising the hip as iliopsoas transfer. Nevertheless 80% of the latter and 61% of the osteotomy patients relied on wheelchairs for mobility.
Weisl
H
H
Royal Infirmary, Cardiff, Wales.
Fairclough
J A
JA
Jones
D G
DG
D002648:Child; D002675:Child, Preschool; D006617:Hip Dislocation / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008124:Locomotion; D008591:Meningomyelocele / Q000601:surgery*; D009132:Muscles / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications; D013710:Tendons / Q000601:surgery; D013848:Thigh