Operative Treatment of Bilateral Hip Dislocation in Children with Arthrogryposis Multiplex Congenita

Author:

Asif S1,Umer M1,Beg R1,Umar M1

Affiliation:

1. Division of Orthopedics, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan

Abstract

Purpose. Arthrogryposis multiplex congenita (AMC) is a rare syndrome with multiple joint contractures. It is commonly believed that bilaterally dislocated hips associated with joint contractures should not be reduced, because movement is satisfactory, while open reduction leads to poor results. This report presents our experience with surgical management of bilateral dislocation of hips in children with AMC. Methods. During the period 1990 to 2000, we performed open reduction on 8 hips of 4 children with AMC. The mean age at surgery was 23 months (range, 5–48 months). Open reduction and capsular plication without any bony procedure were performed in 4 hips (2 patients). De-rotation and varus osteotomy of the femur was performed in 4 hips, and Salter osteotomy of the innominate bone in 2 hips. The average acetabular index was 44°, and the mean centre-edge angle was −41° preoperatively. Results. The average follow-up period was 4 years (range, 2–9 years). The average acetabular index and centre-edge angle were 19° and 18°, respectively at the time of last follow-up. All children could walk without support. One child required re-opening for redislocation of hip joint. The clinical results were good in 6 hips and fair in 2 hips, according to Severin's and McKay's classifications. Conclusion. Our experience shows that open reduction for bilateral dislocation of hips in children with AMC is a suitable option with generally good results. Surgery performed at earlier age gives the best functional outcome.

Publisher

SAGE Publications

Subject

Surgery

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1. Open reduction for hip dislocation in children with arthrogryposis multiplex congenital: Outcomes of a systematic review;Journal of Clinical Orthopaedics and Trauma;2024-06

2. Top Ten Adult Manifestations of Childhood Hip Disorders;Radiologic Clinics of North America;2020-05

3. Early open reduction of dislocated hips using a modified Smith-Petersen approach in arthrogyposis multiplex congenita;BMC Musculoskeletal Disorders;2020-03-04

4. Treatment and outcomes of arthrogryposis in the lower extremity;American Journal of Medical Genetics Part C: Seminars in Medical Genetics;2019-09

5. Muscle and joint function in children living with arthrogryposis multiplex congenita: A scoping review;American Journal of Medical Genetics Part C: Seminars in Medical Genetics;2019-07-27

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