Staged reconstruction of unilateral neglected hip dislocation through total hip arthroplasty and subsequent intramedullary femoral lengthening.
Developmental dysplasia of the hip
Intramedullary lengthening
Neglected hip dislocation
PRECICE® nail
Subtrochanteric shortening osteotomy
Total hip arthroplasty
Journal
International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
23
03
2021
accepted:
25
05
2021
pubmed:
29
6
2021
medline:
15
12
2021
entrez:
28
6
2021
Statut:
ppublish
Résumé
Total hip arthroplasty (THA) is a successful approach to treat unilateral symptomatic neglected hip dislocation (NHD). However, the extensive leg length discrepancy (LLD) can hereby only be partially corrected. In case of residual LLD of more than 2 cm, subsequent femoral lengthening can be considered. Retrospective analysis of clinical data and radiographs of five patients (age 38.1 (28-51) years) with unilateral NHD who underwent THA with (n = 3) or without (n = 2) subtrochanteric shortening osteotomy (SSO) and secondary intramedullary femoral lengthening through a retrograde magnetically-driven lengthening nail (follow-up 18.4 (15-27) months). LLD was 51.0 (45-60) mm before and 37.0 (30-45) mm after THA. Delayed bone union at one SSO site healed after revision with autologous bone grafting and plate fixation. Subsequent lengthening led to leg length equalisation in all patients. Complete consolidation was documented in all lengthened segments. Staged reconstruction via THA and secondary femoral lengthening can successfully be used to reconstruct the hip joint and equalise LLD. The specific anatomical conditions have to be taken into consideration when planning treatment, and patients ought to be closely monitored.
Sections du résumé
BACKGROUND AND PURPOSE
Total hip arthroplasty (THA) is a successful approach to treat unilateral symptomatic neglected hip dislocation (NHD). However, the extensive leg length discrepancy (LLD) can hereby only be partially corrected. In case of residual LLD of more than 2 cm, subsequent femoral lengthening can be considered.
PATIENTS/MATERIAL/METHODS
Retrospective analysis of clinical data and radiographs of five patients (age 38.1 (28-51) years) with unilateral NHD who underwent THA with (n = 3) or without (n = 2) subtrochanteric shortening osteotomy (SSO) and secondary intramedullary femoral lengthening through a retrograde magnetically-driven lengthening nail (follow-up 18.4 (15-27) months).
RESULTS
LLD was 51.0 (45-60) mm before and 37.0 (30-45) mm after THA. Delayed bone union at one SSO site healed after revision with autologous bone grafting and plate fixation. Subsequent lengthening led to leg length equalisation in all patients. Complete consolidation was documented in all lengthened segments.
CONCLUSION
Staged reconstruction via THA and secondary femoral lengthening can successfully be used to reconstruct the hip joint and equalise LLD. The specific anatomical conditions have to be taken into consideration when planning treatment, and patients ought to be closely monitored.
Identifiants
pubmed: 34181034
doi: 10.1007/s00264-021-05099-x
pii: 10.1007/s00264-021-05099-x
pmc: PMC8626415
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3083-3090Informations de copyright
© 2021. The Author(s).
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