Bilateral dislocation of the hip in spina bifida: A long-term follow-up study

Nineteen patients with spina bifida and bilateral dislocation of the hips w ere studied with a minimal follow-up of 10 years. The average age at review was 21 years (range, 10-31). Ten patients had an upper neurologic level (t horacic to L3), and nine had a low lesion (L4 to sacrum). Three patients ha d no hip surgery. A closed or open reduction was performed in 12 hips, supp lemented by one or more surgical procedures. Of these, 10 remained enlocate d, and two had redislocated. In all other hips, several surgical procedures were performed, aimed at improvement of hip-flexion deformity or stability . At follow-up, one patient had occasional pain in one hip, which was dyspl astic. Of the 10 patients with a high lesion, only two were walkers, but bo th had bilateral dislocation of the hips at follow-up. In contrast, all nin e patients were walkers, but four of these had bilateral dislocation at fol low-up. We found that a level pelvis and good range of motion of the hips a re more important for ambulation than is reduction of bilateral hip disloca tion.