Function of dislocated hips in children with lower level spina bifida

Area of Science:

• Pediatric Orthopedics
• Spinal Cord Injury Research

Background:

• Spina bifida can lead to hip dislocations, impacting mobility in children.
• Assessing functional outcomes of hip dislocation treatment in pediatric spina bifida is crucial.

Purpose of the Study:

• To compare the functional outcomes of operative versus conservative treatment for dislocated hips in children with spina bifida.
• To evaluate the impact of surgical hip relocation on ambulation and energy expenditure.

Main Methods:

• Retrospective review of 52 children (born 1974-1985) with L3-L4 spina bifida and dislocated hips.
• Physical, radiological, and functional assessments using HIS, CHAQ, and Hoffer's ambulation levels.
• Metabolic energy consumption during walking measured in a subgroup of 12 patients.

Main Results:

• No significant difference in function between operative (30 patients) and conservative (22 patients) groups.
• Failed surgical hip relocations resulted in worse functional outcomes compared to successful surgeries and conservative treatment.
• Operated patients demonstrated a 30% more energy-efficient gait compared to non-operated patients.

Conclusions:

• Surgical relocation of dislocated hips in pediatric spina bifida provides marginal functional benefits.
• Failed surgical outcomes negatively impact patient function, highlighting the importance of surgical success.
• Conservative management may be a viable alternative given the limited benefits of surgery.