Unilateral dislocation of the hip in spina bifida. A long-term follow-up.
We reviewed 16 patients with spina bifida and unilateral dislocation of the hip at an average age of 17 years. Nine had a high neurological level (thoracic to L3) and seven a low lesion (L4 to sacral). We assessed the influence of unilateral dislocation of the hip on leg-length discrepancy, hip pain, hip stiffness and pressure sores of the ischial tuberosity. In non-walking patients with high-level lesions, unilateral dislocation gave little functional disability and did not appear to require reduction. In walking patients with low-level lesions, leg-length discrepancy led to a poor gait and functional problems which could be prevented by reduction of the dislocation. In all patients with low lesions, surgery was successful in maintaining reduction; in two of five patients with high lesions it was unsuccessful.
Fraser
R K
RK
Royal Children's Hospital, Parkville, Victoria, Australia.
Bourke
H M
HM
Broughton
N S
NS
Menelaus
M B
MB
D000293:Adolescent; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000150:complications* / Q000601:surgery; D006801:Humans; D007223:Infant; D007870:Leg Length Inequality / Q000209:etiology; D008297:Male; D016135:Spinal Dysraphism / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome