Tendon transfers in the paralytic hip.

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Reconstructive Surgery

Background:

• Flaccid paralysis of the hips significantly impairs mobility and hip joint stability.
• Abductor muscle weakness is a common challenge in managing paralytic hip disorders.
• Surgical interventions are often necessary to restore function and prevent further complications.

Purpose of the Study:

• To evaluate the efficacy of iliopsoas or external oblique muscle transfers in augmenting hip abductor power.
• To assess the impact of these muscle transfers on hip stability and the need for bracing in patients with paralytic hip disorders.

Main Methods:

• Analysis of outcomes in 149 patients undergoing iliopsoas or external oblique muscle transfers for paralytic hip disorders.
• Inclusion of data from over 800 supplemental lower extremity procedures performed concurrently.
• Assessment of hip stability (subluxation/dislocation) and brace dependency before and after surgical intervention.

Main Results:

• Twenty-three of thirty-eight subluxated or dislocated hips achieved stability post-transfer.
• All hips that were stable prior to the transfer maintained their stability.
• Thirty-seven patients transitioned from brace dependency to being brace-free following the procedure.

Conclusions:

• Transfers of the iliopsoas or external oblique muscles are valuable surgical adjuncts for treating paralytic hip disorders.
• These procedures demonstrate significant effectiveness in improving hip stability and functional independence.
• Muscle transfer surgery offers a viable option for enhancing abductor function in pediatric and adult patients with hip paralysis.