Strategies of hip management in neuromuscular disorders:CMT, DMD, SMA, AMC

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Hip Int. 2009 Jan-Mar;19 Suppl 6:S46-52.

Strategies of hip management in neuromuscular disorders: Duchenne Muscular

Dystrophy, Spinal Muscular Atrophy, Charcot-Marie-Tooth Disease and

Arthrogryposis Multiplex Congenita.

Canavese F, Sussman MD.

Department of Orthopedics, Shriners Hospital for Children, 3101 SW Sam

Park Road, Portland, OR 97239, USA.

Joint contractures, subluxation and dislocation are common problem in children

with neuromuscular disorders. Medical, surgical and rehabilitative approaches

can be used to maintain patient function and comfort. Contracture release, hip

dysplasia correction and procedures to address or prevent hip subluxation or

dislocation, are not always necessary since patients can be asymptomatic and

surgical treatment will not always be successful in maintaining a reduced hip.

In fact, controversy surrounds the management of hip disorder in children with

Duchenne Muscular Dystrophy, Spinal Muscular Atrophy, Charcot-Marie-Tooth

Disease and Arthrogryposis Multiplex Congenita.

Patients with neuromuscular disorders also frequently develop a progressive

scoliosis with pelvic obliquity which may affect sitting balance and become

painful. Most subluxations and dislocations have the tendency to occur on the

high side of a tilted pelvis. Spinal stabilisation is sometimes necessary to

improve the pelvic tilt and to prevent further increase. The present article

provides an overview of the current strategies of hip management in

neuromuscular disorders.