Proximal femoral resection for older children with spastic hip disease

Thirteen patients (19 hips) who underwent proximal femoral resection arthroplasty for symptomatic subluxation or dislocation of the hip were reviewed retrospectively. All had severe neurological involvement, and when older were non-ambulatory with spastic quadriplegia or myelodysplasia. Resections were either at the level of the neck (nine hips) or in the subtrochanteric region (10 hips). The latter provided a better operative result than did the former. Poor clinical results noted were continued pre-operative pelvic obliquity, postoperative adduction contracture, and bony contact between the pelvis and the remaining proximal femur or its heterotopic ossification.