Iliopsoas Muscle Transfer in the Treatment of Myelomeningocele Patients

Although the problems relating to the hip joints of patients with myelornenin-gocele may not be the most pressing concern of physicians caning for these patients, the importance ofgood hip function should not be underestimated, particularly in the severely paralyzed patient. Deformities of the hips may make walking difficult or irn-possible, and muscle imbalance may lead to lumbar lordosis on subluxations and dis-locations ofthe hip The neurological lesions in children with myelomeningocele vary considerably. Many of these children have distinct levels of neurological deficit but in sonic the Ic-sions cannot be so delineated and these lesions are called incomplete. Sharrard has described in detail the changes in the hip joint that are associated with complete Ic-sions at various levels. The total or partial paralysis of the gluteal muscles is corn-mon whenever a complete or incomplete lesion exists above the sacral level and often causes muscle imbalance at the hip. The greater relative strength of the hip flexors and adductons can then cause a deformity of the hip. The type and severity of the de-fonmity are dependent, in part at least, upon the degree of imbalance