Scoliosis and flexion contracture of the hip in Duchennes muscular dystrophy.

Spinal deformity is common in muscular dystrophy and usually occurs after l oss of walking ability. Unlike in idiopathic and other scoliosis forms, the re seems to be no side preference of the convexity. Aim of the study was to analyse, if there is any relation between incidence and extent of walking ability, lower limb contractures and development of scoliosis. Methods: In a retrospective study, 45 patients with Duchenne muscular dystrophy who und erwent surgery were analysed, concerning walking ability, contractures of l ower extremities and scoliosis. Results: 1: No scoliosis was observed in am bulatory patients. 2: 96% of the wheelchair bound patients suffered from sc oliosis. 3: 96% of the scoliosis patients had hip flexion or abduction cont ractures. 4: In 12 of 15 cases with side- different contractures, scoliosis tended to the side with the greater contracture. Conclusions: The influenc e of hip contracture and pelvic obliquity on scoliosis is discussed controv ersially. Concerning muscular dystrophy, there seems to be a positive corre lation between convexity and hip contracture. If this is a causal relation or if there is a faster progression of structural alteration of the muscles on one side has to be further investigated.