Myelomenningocele Hip


Myelomeningocoele is a congenital disorder of the lower spinal cord that can cause asymmetric muscle weakness and lack of sensation in the legs. The level of involvement can be high at the thoracic level or upper lumbar level with no capacity for independent ambulation, lower lumbar level with ability to walk with braces and crutches, and sacral level with good function in the legs.  Hip dislocation is more common in proximal levels.

Hip dislocation in Sacral level or children who not waddle at the hips are treated like idiopathic DDH with reduction.

Low lumbar level who can ambulate well, but lack hip abductors, use AFOs and crutches lifelong. These hips do not seem to benefit from reduction and the hip may not stay in after reduction. Hence these are left dislocated focusing on correcting only contractures and leg length difference.

Higher levels do not need treatment of hip dislocation beyond releasing contractures and preventing pressure sores.