Hinge abduction hip dysplasia in (morquio a syndrome) treated by proximal femoral valgization osteotomy: a rare case report.

Abstract

A 10-year-old girl suffering from MPS IVA with many signs of orthopedic manifestations. When concentrating on the hip joint, she had acetabulofemoral dysplasia and hinge abduction hip with the aid of plain radiographs and arthrography with dynamic testing. A valgization osteotomy of the proximal femur in combination with a shelf acetabuloplasty was performed bilaterally. There is no documented case of valgus osteotomy of the proximal femur in MPS IVA patients. Furthermore, preoperative arthrographies are not described as a routine diagnostic tool, because the routine surgical procedure was to do varus osteotomy with a high rate of failure. In our opinion, understanding of the dynamic function of the hip is essential for the surgical decision-making process. Our successful case with an 8-year follow-up illustrates that the well-known and widely performed valgus osteotomy in cases of hinge abduction in MPS IVA is an alternative, which should be considered preoperatively.