title: OPEN REDUCTION OF HIP DISLOCATION IN PATIENTS WITH ARTHROGRYPOSIS MULTIPLEX CONGENITA - AN ANTEROMEDIAL APPROACH.
abstract: To evaluate the results from surgical treatment of hip dislocation through the anteromedial approach, in patients with arthrogryposis multiplex congenita (AMC).
  
  
  METHODS
  The medical files and radiographs of seven children with AMC who presented hip dislocation (total of 10 dislocated hips) were retrospectively reviewed. Pre and postoperative joint mobility was evaluated by summing the joint range of motion in flexion and abduction. The acetabular angle and height of the femoral neck before the operation, and the continuity of the Shenton arc, Sharp angle and center-edge (CE) angle after the operation, were evaluated radiographically. When avascular necrosis was identified, it was classified in accordance with Ogden and Bucholz.
  
  
  RESULTS
  The mean age of the children at the time of the surgery was 5.5 months (range: 3 to 11 months). The mean duration of follow-up for the patients was 9.5 years (range: 2 to 13 years). The mean amplitude of the sum of the joint range of motion in flexion and abduction in the preoperative examination was 108° (range: 70° to 155°) and postoperatively, it was 125° (range: 75° to 175°). In the last evaluation, eight hips were found to be centered and two were subluxated. Two hips had been subjected to Salter iliac osteotomy. Two hips (20%) had presented significant signs of Ogden type IV avascular necrosis. Eight hips had good results while two were fair.
  
  
  CONCLUSIONS
  We consider that the anteromedial approach is a good option for treating hip dislocation in very young patients with arthrogryposis multiplex congenita.
authors.affiliation: Orthopedist at Hospital Pequeno Príncipe (HPP), Curitiba, PR, Brazil.
authors.forename: Luis Eduardo Munhoz da
authors.initials: LE
authors.lastname: Rocha
authors.affiliation: Resident in Orthopedics and Traumatology, Hospital Pequeno Príncipe (HPP), Curitiba, PR, Brazil.
authors.forename: Fábio Koiti
authors.initials: FK
authors.lastname: Nishimori
authors.affiliation: Orthopedist at Hospital Pequeno Príncipe (HPP), Curitiba, PR, Brazil. Specializing in Pediatric Orthopedics.
authors.forename: Daniel Carvalho de
authors.initials: DC
authors.lastname: Figueiredo
authors.affiliation: Orthopedist at Hospital Pequeno Príncipe (HPP), Curitiba, PR, Brazil.
authors.forename: Dulce Helena
authors.initials: DH
authors.lastname: Grimm
authors.affiliation: Orthopedist and Head of the Pediatric Orthopedics Service, Hospital Pequeno Príncipe (HPP), Curitiba, PR, Brazil.
authors.forename: Luiz Antonio Munhoz da
authors.initials: LA
authors.lastname: Cunha
keywords: Arthrogryposis; Hip Dislocation; Surgical Procedures, Operative