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PROXIMAL TENSOR FASCIALATA (TFL) RELEASE IN PAEDIATRIC AND ADOLESCENT SNAPPING HIPS



Abstract

Aim: Assessment of the management of painful paediatric snapping hips by a novel alternative, ie. proximal TFL release.

Materials and Methods: A retrospective study was undertaken between 1989 – 2002, reviewing 15 patients (21 hips) who had had proximal tensor fascia lata release. Diagnosis was made on the basis of history and physical examination. All hips were X-rayed and other causes of an audible snap were excluded. Physiotherapy had been attempted in all cases and most had failed to improve pre-operatively. All cases were followed up for a minimum period of 6 months.

Results: There were 2 males and 13 females. The mean age of operation was 15 years. 2 hips required a revision procedure. 81% had a pain-free, non-snapping hip at the time of discharge. There was 1 case of numbness in the thigh secondary to damage to the lateral cutaneous nerve of the thigh. No cases had a long-term Trendelenberg limp.

Conclusion: It was felt that proximal release of the tensor fascia lata from the pelvis is a good operation for painful, snapping hips with an excellent result in 81%. This has a similar success rate to the Brignall & Stainsby procedure, ie. Z-plasty of the tensor fascialata.

The abstracts were prepared by the Editorial Secretary Robin W Paton. Correspondence should be addressed to him c/o BOA, 35–43 Lincoln’s Inn Field, London WC2A 3PN.