The role of hip location and dislocation in the functional status of the myelodysplastic patient. A review of 100 patients.

One hundred patients 10 years of age or older with myelodysplasia were evaluated to compare located versus dislocated hips with regard to neurologic level, ambulation, hip pain, skin condition, and spinal deformity. Operated and nonoperated individuals were compared. Analysis was carried out to determine what the overall long-time function was in located, dislocated, and "relocated" individuals. Of the 100 patients, 72 presented at follow up with bilateral located hips, 18 with unilateral hip dislocations, and 10 with bilateral dislocations. Twenty patients functioned at T12 levels or above, 30 patients had preservation of anterior thigh musculature, and 25 patients had posterior leg or hip abductor power. Thirteen patients (15 hips) were found to have some degree of pain, 1 patient with bilateral dislocation, 5 with unilateral dislocation, and 7 with bilaterally located hips. Ambulatory function was not affected in any neurologic group by location versus dislocation of the hips. Skin ulceration problems were not increased in patients with hip dislocation. Major spinal deformity in most groups correlated highly with neurologic levels, but not with location versus dislocation of the hips. In one group, an increase in lumbar lordosis was present in unilateral hip dislocations. This study suggests that adolescents and young adults with myelodysplasia have different functional levels related to the neurologic level which are not related to whether the hips are located or dislocated.