Proximal Femoral Reorientational Osteotomies for the Hip Deformities in Children with Arthrogryposis Multiplex Congenita
Children with arthrogryposis and severe hip contractures face great difficulties with ambulation and often even with comfortable positioning for seating. These multiplanar joint deformities are a challenge for treatment. The surgical goal is to align the lower extremity in a functional position relative to the body, exploiting the most optimal range of hip motion available. While flexion or flexion-abduction contractures can be improved with a percutaneous anterior soft tissue release of the hip, the more severe contractures can reliably be corrected with a reorientational osteotomy of the proximal femur. This procedure leaves the actual “ball in socket” hip joint undisturbed but aligns the lower extremity with the body axis.