An 11-year-old with CdLS has two hips that are subluxed (migration percentage 50%). There has been very little change over the last year or so. The child weighs 28 pounds and has just had a fundoplication for gastroesophageal reflux. Could you give me information on the natural history of hip subluxation in CdLS?
The natural history of hip subluxation in CdLS is similar to that in typical children. If your patient is not walking, it is likely that at least one hip will progress to further lateralization or dislocation. If she does walk, the subluxation may increase, but probably very slowly. I have treated 50% subluxations in CdLS operatively, doing just varus and/or derotation femoral osteotomies if the acetabulum is normal, but adding an acetabular procedure (Salter, modified Dega, etc) if this is necessary to correct acetabular dysplasia. I have not seen any problems with healing or recurrent subluxation postoperatively.
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