Pelvic Support Osteotomy; Salvage Procedure in Chronically Dislocated Hips Case Report: Technical Note on the On-lay Bone Positioning of a Lengthening Nail and Review of the Literature

Open Orthop J. 2016 Jun 29:10:232-40. doi: 10.2174/1874325001610010232. eCollection 2016.

Abstract

Background: Young patients with a acquired dislocation of the hip with concomitant shortening of the lower limb is a difficult diagnostic problem with few definite treatment options.

Methods: We used the technique, originally described by Ilizarov, with a double femur osteotomy and lengthening the femur. Lengthening was done with a sub muscular placed on-lay femur distraction rod. Distraction of the rod was done by fluid mechanics. After lengthening, the distraction was secured by a parked plate by locking the distal part of the plate.

Results: This patient needed a lengthening of 60 mm, distraction time was 36 days with a distraction index of 1.61 mm per day and a healing index of 31.4 days per cm lengthening.We encountered one complication in which an exchange of the plastic feeding tube was needed at 20 days post-surgery.

Conclusions: In the reported case we could improve gait with reduced limping and equalizing her leg length discrepancy.

Keywords: Bone lengthening; Congenital hip dislocation; Hydraulics Ilizarov technique; Lengthening nails; Pelvic osteotomies.