The Journal of Bone and Joint Surgery, Vol 60, Issue 2 169-173, Copyright © 1978 by Journal of Bone and Joint Surgery, Inc
The effect of hip reduction on function in patients with myelomeningocele. Potential gains and hazards of surgical treatment
E Feiwell, D Sakai and T Blatt
We studied seventy-six patients with myelomeningocele who were more than
five years old and ahd had no hip surgery during the two previous years. Of
these seventy-six patients, forty-one had had no operative treatment
intended to reduce the dislocation of their hips and thirty-five had been
operated on one or more times to reduce or maintain reduction of one or
both hips. The presence of the femoral head in the acetabulum did not
improve range of hip motion or ability to walk, nor did it reduce the
amount of bracing required or decrease pain. The complications of surgical
treatment to gain reduction were numerous and included failure to obtain
stability in 40 per cent of the hips, loss of hip motion, and fractures. A
level pelvis and a good range of hip motion were found to be more important
for function than reduction of the hips. The goal of treatment should be
maximum function, not roentgenographic reduction of the dislocated hip.
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