A New Operation for Hip Contractures in Poliomyelitis

Soutter, Robert

doi:10.1056/nejm191403121701105

Cited by 20 publications

(2 citation statements)

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“…Soutter’s release: 8 Contractures around the hip were in flexion, either alone or associated with abduction. A short transverse incision of around 5 cm was given two finger breadths inferior to the anterior superior iliac spine.…”

Section: Methodsmentioning

confidence: 99%

An algorithmic approach to total hip arthroplasty in patient with post-polio paralysis and fixed pelvic obliquity

et al. 2021

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Aims Total hip arthroplasty (THA) in patients with post-polio residual paralysis (PPRP) is challenging. Despite relief in pain after THA, pre-existing muscle imbalance and altered gait may cause persistence of difficulty in walking. The associated soft tissue contractures not only imbalances the pelvis, but also poses the risk of dislocation, accelerated polyethylene liner wear, and early loosening. Methods In all, ten hips in ten patients with PPRP with fixed pelvic obliquity who underwent THA as per an algorithmic approach in two centres from January 2014 to March 2018 were followed-up for a minimum of two years (2 to 6). All patients required one or more additional soft tissue procedures in a pre-determined sequence to correct the pelvic obliquity. All were invited for the latest clinical and radiological assessment. Results The mean Harris Hip Score at the latest follow-up was 79.2 (68 to 90). There was significant improvement in the coronal pelvic obliquity from 16.6o (SD 7.9o) to 1.8o (SD 2.4o; p < 0.001). Radiographs of all ten hips showed stable prostheses with no signs of loosening or migration, regardless of whether paralytic or non-paralytic hip was replaced. No complications, including dislocation or infection related to the surgery, were observed in any patient. The subtrochanteric shortening osteotomy done in two patients had united by nine months. Conclusion Simultaneous correction of soft tissue contractures is necessary for obtaining a stable hip with balanced pelvis while treating hip arthritis by THA in patients with PPRP and fixed pelvic obliquity. Cite this article: Bone Jt Open 2021;2(9):696–704.

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Section: Methodsmentioning

confidence: 99%

An algorithmic approach to total hip arthroplasty in patient with post-polio paralysis and fixed pelvic obliquity

et al. 2021

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“…Abductor fasciotomy. Our technique is identical to that of Eberle's 8 modification of the original Soutter 9 and Campbell 10 procedures.…”

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confidence: 96%

Fixed Pelvic Obliquity After Poliomyelitis: Classification And Management

Lee

Choi

Chung

et al. 1997

The Journal of Bone and Joint Surgery

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We classified fixed pelvic obliquity in patients after poliomyelitis into two major types according to the level of the pelvis relative to the short leg. Each type was then divided into four subtypes according to the direction and severity of the scoliosis. In 46 patients with type-I deformity the pelvis was lower and in nine with type II it was higher on the short-leg side. Subtype-A deformity was a straight spine with a compensatory angulation at the lower lumbar level, mainly at L4-L5, subtype B was a mild scoliosis with the convexity to the short-leg side, subtype C was a mild scoliosis with the convexity opposite the short-leg side, and subtype D was a moderate to severe paralytic scoliosis with the convexity to the short-leg side in type I and to the opposite side in type II. A combination of surgical procedures improved the obliquity in most patients. These included lumbodorsal fasciotomy, abductor fasciotomy and stabilisation of the hip by triple innominate osteotomy with or without transiliac lengthening. In patients with type ID or type IID appropriate spinal fusion was usually necessary.

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Operative Treatment of Cerebral Palsy of Spastic Type

Green¹,

McDERMOTT²

1942

JAMA

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Among the 160 cases there were 9 instances of monoplegia, 73 of hemiplegia, 51 of paraplegia, 2 of triplegia and 25 of quadriplegia.• Seventy-nine of the patients were considered mentally normal and 27 questionably so. Thirty-seven were definitelv retarded and 30 were feebleminded.Before the data are considered from this survey, it is well to consider our attitudes regarding the position of surgical procedures in the treatment of spastic paralysis, since in general the patients were chosen for operation with these considerations in mind. POSITION OF SURGERY IN TREATMENT

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A New Operation for Hip Contractures in Poliomyelitis

Cited by 20 publications

References 0 publications

An algorithmic approach to total hip arthroplasty in patient with post-polio paralysis and fixed pelvic obliquity

An algorithmic approach to total hip arthroplasty in patient with post-polio paralysis and fixed pelvic obliquity

Fixed Pelvic Obliquity After Poliomyelitis: Classification And Management

Operative Treatment of Cerebral Palsy of Spastic Type

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