Open Reduction of Congenital Dislocation of the Hip with Arthrogryposis Multiplex Congenita

Congenital dislocation of the hip with arthrogryposis multiplex congenita is more difficult to treat than developmental dislocation of the hip by either nonsurgical or surgical means. We treated 5 patients (7hips) surgically from 1980 to 1995. The average age at the time of surgery was approximately 2 years, except for 1 patient who was operated on when aged 7 years. Four patients (6hips) were treated by open reduction (O. R.), derotation-varus osteotomy (D. V. O), and shelf operation or pelvic osteotomy. One patient (1hip) was treated by O. R. and D. V. O. Reduction was relatively successful in all patients, with no recurrence of dislocation. Range of motion of the hip could be maintained by aggressive and continuous motion exercise which was commenced 4 weeks after surgery with the removal of the hip spica cast.