Proximal femoral resection-interposition arthroplasty.

In the severely retarded, multiply handicapped child who has a dislocated hip and severe adduction of the lower extremity, the deformity often interferes with perineal hygiene, nursing care, and positioning in bed and in a wheelchair. In twelve such patients we did an extensive resection of the proximal part of the femur, down to below the lesser trochanter, and constructed a capsular flap across the acetabulum. The quadriceps muscle was sutured around the resected end of the femur. This one-stage, uncomplicated operation allowed our patients to sit confortably and nursing care was made easy. In contrast, three patients who had single resection of the femoral head and neck had recurrence of deformity and pain.