MEDIAL-APPROACH OPEN REDUCTION OF HIP DISLOCATION IN AMYOPLASIA-TYPE ARTHROGRYPOSIS

In 95 children with amyoplasia-type arthrogryposis multiplex congenita , 40 hip dislocations in 26 patients were found. In 16 of these 26 pat ients, bilateral (nine patients) and unilateral (seven patients) dislo cations were reduced by a medial-approach open reduction. The mean age at the time of surgery was 8.9 months. Acetabular development was sat isfactory. Complications included one early redislocation, two hips wi th stiffness, and four of 25 hips with avascular necrosis (types 1 and 2). Overall 80% (five of seven unilateral, 15 of 18 bilateral hips) w ere rated good and 12% fair, and 8% (one of seven unilateral, one of 1 8 bilateral) were poor. Stiffness or asymmetry was not observed in the nine bilateral cases. This study suggests that dislocations in infant s with amyoplasia may be successfully reduced by medial-approach open reduction. Bilateral reduction and concurrent correction of other lowe r limb contractures may be accomplished during the same surgical sessi on.