The orthopaedic manifestations in children with myelomeningocele at Mulago hospital.

Abstract

Myelomeningocele is a developmental defect in the vertebral arches and the spinal cord, characterized by a failure of fusion of the vertebral arches with dysplasia of the cord and its membranes. It is a form of Spina bifida, aperta with a variable defect in the vertebral arch of the spinal column. Bifida is from the Latin bifidus or left in 2 parts. Spina bifida is the commonest birth defect among live born infants and 94% of which is myelomeningocele1. The incidence of myelomeningocele varies in different parts of the world though it is estimated at 1-4 per 1000 population2, 3, 3, 4, 5. It is slightly more common in females than males with a ratio of 1.5.16. Sibling recurrence is 2-3%1. Children with myelomeningocele present with a number of orthopaedic manifestations involving the spine, hip, knee, foot and ankle, and torsion deformities7, 8. Mulago Hospital has a Neurosurgical unit of which approximately 80 children with myelomeningocele are seen per year. However, these patients are hardly seen in the orthopaedic clinics, only three patients were seen in orthopaedic clinics in the year 2003 and only one patient has had surgery in the last five years. This study described the orthopaedic manifestations in myelomeningocele patients and therefore assessed the burden of the problem and the need for orthopaedic management of these patients at Mulago Hospital.