{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T09:15:15Z","timestamp":1783588515349,"version":"3.55.0"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Introduction: Hip dislocation is a rare secondary complication due to neuromuscular dysfunction in organic acid disorders like methylmalonic acidemia (MMA). Surgical intervention in patients with metabolically driven basal ganglia lesions presents unique challenges for both physiological stability and mechanical success.\n\nCase Report: An 11-year-old boy with late-onset MMA presented with generalised spasticity, involuntary movements, and a left hip deformity in flexion, adduction, and internal rotation. Imaging confirmed a left hip dislocation associated with coxa valga and caput valga. The patient was managed initially with muscle relaxants followed by surgical intervention consisting of a closed reduction, proximal femoral varus osteotomy, adductor tenotomy and a medial femoral caput epiphysiodesis. Post-operative management utilised an abduction brace; however, persistent spasticity created significant challenges in maintaining hip stability and compliance with the orthosis. Conclusion: Surgical management of hip dislocation in MMA requires addressing both the bony deformity and the underlying neuromuscular forces. While anatomical reduction is achievable, aggressive management of spasticity is critical to prevent recurrence in the acute post-operative period.\n\nConclusion: Methylmalonic acidemia, organic acid disorders, neuromuscular hip dislocation, coxa valga, caput valga, proximal femoral varus osteotomy.<\/jats:p>","DOI":"10.13107\/jocr.2026.v16.i07.7620","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T08:35:16Z","timestamp":1783586116000},"page":"155-160","source":"Crossref","is-referenced-by-count":0,"title":["Orthopedic Intervention in an Organic Acid Disorder: Challenges in the Management of Hip Dislocation in a Child with Late Onset Methylmalonic Acidemia"],"prefix":"10.13107","volume":"16","author":[{"given":"David Gregg Smith","family":"Ponraj","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Sitsabesan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P Gopinath","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjith Kumar","family":"Manokaran","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Lakshmi","family":"Narasimhan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5271","published-online":{"date-parts":[[2026]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T08:35:17Z","timestamp":1783586117000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2026\/07\/orthopedic-intervention-in-an-organic-acid-disorder-challenges-in-the-management-of-hip-dislocation-in-a-child-with-late-onset-methylmalonic-academia\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2026.v16.i07.7620","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}