Painful spastic hip dislocation: proximal femoral resection.
The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despite routine post-operative skeletal traction in all cases and careful soft tissue interposition. One case showed significant heterotopic ossification which restricted prolonged sitting. This patient needed some occasional medication for pain.
Pediatric Orthopaedic Division, Hospital Niño Jesus, Madrid, Spain. albinanat@navegalia.com
Javier
J
Albiñana
Gaspar
G
Gonzalez-Moran
D000293:Adolescent; D002648:Child; D005260:Female; D006617:Hip Dislocation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D009999:Ossification, Heterotopic / Q000150:complications; D011782:Quadriplegia / Q000150:complications; D011859:Radiography; D012189:Retrospective Studies