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.