Hip stability and ambulatory status in myelomeningocele

Fifty-three hips in 32 patients with myelomeningocele and innervation to the quadriceps were surgically stabilized. In most cases, all the surgical procedures necessary to achieve stability were performed at the same time. Preoperatively, 92.5% of the hips were either subluxated or dislocated; the rest were dysplastic. At the time of review, an average of 4 years 1 month following surgery, 83% of the hips were stable. Of the children, 78% were community ambulators. Ambulatory status was found to be adversely affected by subsequent development of spinal deformity, hip flexion deformity, or lordosis and by age. Children with myelodysplasia who have strong quadriceps and stable neurological status can therefore have surgical stabilization of their hips with good results.