Pelvic Girdle

Affects of MHE on the Pelvic Girdle

Osteochondromas of the proximal femur may lead to progressive hip dysplasia. There have been reported cases of acetabular dysplasia with subluxation of the hip in patients with MHE. This results from exostoses located within or about the acetabulum that may interfere with normal articulation.
Pelvic lesions may be found on both the inner as well as outer aspect of the pelvic blades. Large lesions may cause signs of compression, both vascular and neurological. There have also been reports of exostoses interfering with normal pregnancy and leading to a higher rate of Cesarean sections.

Diagnostic Procedures

Manual palpation is sometimes very difficult in these deep lesions. The orthopedist will check range of motion (“ROM”) by manipulating (moving) the leg in different directions. The orthopedist will also check measurements on each leg to see if there is a difference in limb lengths. X-rays or other imaging tests may be ordered.

Possible Treatment Options

Minor length discrepancies can sometimes be effectively treated with the use of orthotics (specially made shoes or lifts that will equalize leg length).
Bowing and some limb length discrepancies can be treated with a surgical procedure called “stapling,” where surgical staples are inserted into the growth plate of the leg bone growing faster than the other. This will hopefully give the slower growing bone the chance to “catch up” and the limb will straighten over time.
Limb Lengthening with a Fixator. (See Section on Fixators)
Pelvic lesions of concern may need to be surgically excised.
Osteotomies.
Hip replacement.

What Parents Should Watch Out For