[The treatment of the hip cotructure with intertrochanteric osteotomy of the femur in children with Arthrogryposis multiplex congenita].

BACKGROUND

The flexion contractures of the hips affect mobility in patients with Arthrogryposis Multiplex Congenita (AMC). There are only a few reports concerning correction of those deformities with femoral intertrochanteric osteotomy.

AIM

The results' analysis of fixed hip flexion deformity correction with femoral intertrochanteric osteotomy in AMC patients.

MATERIAL

16 femoral intertrochanteric osteotomies were performed for hip contracture between 1992 and 2002 in 7 AMC patients. Mean follow up period was 6.5 years postoperatively. The hip contractures between 20 and 110 degrees making mobility impossible or difficult fulfilled the criteria for surgery. In 7 cases knee flexion deformity correction was performed simultaneously with the hip procedure. At the final check up, the hip ROM, the rate of deformity recurrence and patients' mobility were assessed.

RESULTS

The mobility was affected in all children preoperatively. The range of deformity correction during the procedure was average 53 degrees. In 10 cases the improvement of mobility status was estimated postoperatively. The deformity recurrence occurred in 13 cases, in 4 of them required procedure to be repeated. The age in the recurrence group was lower and the contractures measured preoperatively more severe in comparison to the non recurrence group.

CONCLUSIONS

Femoral intertrochanteric osteotomy tends to be efficient method of treatment of hip flexion contracture in children with AMC. Deformity correction has been achieved in all patients. The mobility status improvement is noted in majority of the patients, despite high rate of deformity recurrence postoperatively.