A Pelvic Support Osteotomy and Femoral Lengthening with Monolateral Fixator

İnan, Muharrem; Bowen, Richard J.

doi:10.1097/01.blo.0000180602.00487.47

Cited by 28 publications

(15 citation statements)

References 30 publications

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“…The lower greater trochanter improves the leverage of the glutei [1,11,17]. The Ilizarov modification of this technique added another distal femoral osteotomy for lengthening and correcting the mechanical axis of the leg [10,12,20].…”

Section: Introductionmentioning

confidence: 99%

Pelvic Support Osteotomy in the Treatment of Patients With Excision Arthroplasty

Emara

2008

Clinical Orthopaedics &Amp; Related Research

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Resistant hip infection in adults can be a complicated problem that does not respond to surgical and medical treatment. In such cases, the only remaining option is excision arthroplasty. This line of treatment can eradicate the infection but also is associated with poor function. In some cases, conversion of excision arthroplasty to artificial joint replacement is associated with too great a risk because of local hip surgical risks or low immunity with risk of recurrent infection. Pelvic support osteotomy with the Ilizarov modification can present an alternative solution for such patients. This study included 11 patients with resistant hip infection who were treated using excision arthroplasty. Pelvic support osteotomy then was used to improve hip stability and abductor muscle function. The Ilizarov modification was applied to correct mechanical alignment of the limb and the limb length discrepancy. Harris hip scores improved in all patients: the average score preoperatively was 43.5 (range, 31-50), whereas at final followup, the average score was 70.9 (range, 65-80). Pelvic support osteotomy, along with the Ilizarov modification, can provide an alternative treatment to improve function in patients previously managed with excision hip arthroplasty and Girdlestone surgery.

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Section: Introductionmentioning

confidence: 99%

Pelvic Support Osteotomy in the Treatment of Patients With Excision Arthroplasty

Emara

2008

Clinical Orthopaedics &Amp; Related Research

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“…In contrast with the procedure described by Ilizarov using a ring assembly [10], we used a hybrid external fixator consisting of the proximal Italian arch assembly connected to a distally applied monolateral fixator using only half pins for fixation. This fixator has the dual advantage of versatility and decreased incidence of knee stiffness [9]. Three of our patients developed knee stiffness owing to prolonged fixator application, and all achieved their preoperative knee range following physical therapy after fixator removal.…”

Section: Discussionmentioning

confidence: 98%

“…Gotoh et al [19] reported a long-term follow-up of 51% survivorship 15 years after valgus-extension osteotomy for advanced osteoarthritis in dysplastic hips. Inan and Bowen [9] claim that the monolateral fixator was suitable for pelvic support osteotomy and for achieving a pain-free, functional hip and good knee motion. Monolateral external fixators have a low incidence of knee stiffness compared with the Ilizarov fixators for the femur.…”

Section: Discussionmentioning

confidence: 98%

“…Pelvic support osteotomy, which was first carried out by Bavoier in 1838 according to Edelson and Taitz and later modified, might be a good solution for young adults [9]. This procedure, which was classically described as a proximal femoral valgus osteotomy, was modified by Ilizarov with the addition of an extension to the proximal osteotomy and a separate distal femoral varus osteotomy [10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bilateral valgus-extension osteotomy of hip using hybrid external fixator in spondyloepiphyseal dysplasia: early results of a salvage procedure

Shetty

Song

Lee

et al. 2008

Journal of Pediatric Orthopaedics B

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The treatment of spondyloepiphyseal dysplasia (SED) congenita patients with severe bilateral hip involvement is difficult because it involves deformities of multiple joints and of the spine. The purpose of this study was to evaluate the results of the procedure described below as a method of treatment for bilateral hip involvement in SED congenita patients. We performed proximal femoral valgus-extension osteotomy with distal femoral varus osteotomy using a hybrid external fixator in eight patients (seven male patients and one female patient) or 16 hips. The patients had a mean age of 16.37 years (range, 9-25 years) at the time of surgery. The mean valgus angle at the proximal osteotomy site was 53.4 degrees on the right side and 52.5 degrees on the left side, and the mean varus angle at the distal osteotomy site was 22 degrees . Mean fixator time was 19.8 weeks (range, 10-42 weeks). After an average follow-up of 25.9 months, the mean modified Harris hip score had improved from 67.9 points to 79.1 points, which was statistically significant (P=0.012). Preoperative knee range of motion was achieved at the last follow-up in all patients. Waddling gait was absent in three patients, reduced in four patients, and was the same in one at the last follow-up. Mean limb length gain was 3.5 cm (range, 0-5 cm), mean limb length discrepancy less than 0.5 cm, and the mechanical axis was realigned in all. In conclusion, our early results suggest that proximal valgus-extension osteotomy with distal femoral varusization can be a useful treatment option in young patients with bilateral hip involvement in SED congenita.

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“…Pelvik osteotomi ise nadir kullanılan bir kurtarma operasyonudur. [9][10][11][12] Her ne kadar standart bir tedavi prosedürü olmasa da biz ihmal edilmiş travmatik kalça çıkıklı hastalarda primer açık redüksiyonun iyi bir seçe-nek olduğunu düşünmekteyiz. Açık redüksiyon öncesi iskelet traksiyonunu yerine redüksiyonda zorlanılırsa femur kısaltma osteotomisinin daha uygun olacağını düşünmekteyiz.…”

Section: Olguunclassified

A very rare case with neglected hip dislocation coexisted with posterior acetabular lip fracture

Uruç

Karabulut²

2011

J Clin Exp Invest

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Neglected hip dislocation is a rare situation among children. The coexistence of acetabulum fracture is less common. The result of treatment depends on the time of diagnosis. Early treatment is mandatory in such cases. Seven years old female brought to our outpatient clinic with the complaints of right hip pain and walking difficulty. Her parents said that she had fallen from a horse one month ago. X-ray and CT showed a posterior dislocation of her right hip and a fracture on her right posterior acetabular lip. We performed an open reduction via posterior approach. Because the hip was unstable we fixed the femoral head to the acetabulum by a Kirshner wire. Pelvipedal cast was applied after the operation for 6 weeks. After 6 months avascular necrosis (AVN) developed on her right femoral head, the range of motion (ROM) of the hip was restricted and she had minimal pain on her right hip. J Clin Exp Invest 2011;2(2):228-31Key words: Neglect, children, traumatic hip dislocation ÖZET Çocuklarda ihmal edilmiş kalça çıkığı nadir görülen bir durumdur. Kalça çıkığına asetabulum kırığının da eşlik etmesi daha da nadir görülür. Ne kadar geç teşhis konursa hastanın yapılacak müdahaleden göreceği yarar aynı oranda azalır. Dolayısıyla bu hastalara erken müdahale etmek hayati önem taşır. 7 yaşında bir kız çocuğu yürüyememe ve sağ kalça ağrısıyla polikliniğimize getirildi. Ailesi hastanın 1 ay önce attan düştüğünü ifade etti. Çekilen düz grafi ve BT'de hastanın sağ kalçasında posteriora çıkık olduğu ve aynı taraf asetabulumun posterior dudağının kırık olduğu tespit edildi. Hastaya posterior yaklaşımlı açık redüksiyon yapıldı. Bir adet kirşner teli ile femur başı asetabuluma tespit edildi. Ameliyat sonrası 6 hafta süreyle pelvipedal alçı uygulandı. Hastanın 6 aylık takibinde femur başında avasküler nekroz (AVN) geliştiği, kalça hareketlerinde kısıtlılık olduğu, hastanın hafif derecede kalça ağrısının olduğu görüldü. Klin Deney Ar Derg 2011;2(2):228-31Anahtar kelimeler: İhmal edilmiş, çocuklarda, travmatik kalça çıkığı GİRİŞÇocuklarda ihmal edilmiş kalça kırıklı çıkığı ile ilgili literatürde az sayıda ve olgu sunumu şeklinde yayınlar bulunmaktadır. Bu hastaların tedavisinde henüz standart bir prosedür oluşmamıştır. Yapılan tedavilerin birbirine üstünlüğünü gösteren bir çalış-ma da literatürde şimdiye kadar yayınlanmamıştır. Biz burada bir ay gecikmeyle travmatik kalça çı-kığı ve asetabulum posterior dudak kırığı olan bir hastaya açık redüksiyon yaptığımız ve femur başını kirşnerle asetabuluma tespit ettiğimiz bir olguyu sunuyoruz. OLGUBir ay önce attan düşme hikayesi olan yedi yaşında kız çocuğu ailesi tarafından polikliniğimize getirildi. Köyde yaşayan aile, hastayı daha önce geleneksel olarak kırıkçılık yapan birisine götürdüklerini bildirdi. Aile kırıkçının, çocuğun kalçasının çıkık olduğunu ve çıkık olan kalçayı yerine oturttuğunu söylemesi nedeniyle hastanın yakınmalarının devam etmesine rağmen 1 ay gecikmeyle hastaneye başvurmuştu. Hastanın çekilen X-ray ve BT'sinde sağ kalçasının posteriora çıkık olduğu ve asetabulu...

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A Pelvic Support Osteotomy and Femoral Lengthening with Monolateral Fixator

Abstract: Therapeutic study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.

Cited by 28 publications

References 30 publications

Pelvic Support Osteotomy in the Treatment of Patients With Excision Arthroplasty

Pelvic Support Osteotomy in the Treatment of Patients With Excision Arthroplasty

Bilateral valgus-extension osteotomy of hip using hybrid external fixator in spondyloepiphyseal dysplasia: early results of a salvage procedure

A very rare case with neglected hip dislocation coexisted with posterior acetabular lip fracture

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