Metikala, S., Kurian, B.T., Madan, S.S. et al. (1 more author) (2020) Pelvic support hip reconstruction with internal devices : an alternative to Ilizarov hip reconstruction. Strategies in Trauma and Limb Reconstruction, 15 (2). pp. 91-97. ISSN 1828-8936
Abstract
Aim and objective: Ilizarov hip reconstruction (IHR) is a traditional method of salvaging chronic adolescent problem hips but faces practical problems from external fixators leading to reduced compliance. We present the same reconstruction utilising only internal devices with a modification in technique and aim to review early results. Materials and methods: We retrospectively evaluated eight patients between 2014 and 2017 with chronic painful hips treated by a two-stage reconstruction; stage 1 included femoral head resection and pelvic support osteotomy using double plating, while stage 2 comprised distal femoral osteotomy avoiding varus followed by insertion of retrograde magnetic nail for postoperative lengthening. Patients continued physiotherapy postoperatively while protecting from early weight-bearing. Results: At mean follow-up of 19 months (range 6–36), all osteotomies healed with bone healing index of 47 days/cm (range 30–72). Pain improved from 8.3 (range 7–9) to 2 (range 0–6), while limb length discrepancy got corrected from 4.3 cm (range 3–5) to 1.4 cm (range 0–2.5) at final follow-up. Trendelenburg sign was eliminated in three and delayed in five. No examples of infection or permanent knee stiffness were noted. One patient had plates breakage due to mechanical fall and one had 35 mm of lateral mechanical axis deviation requiring corrective osteotomy. Conclusion: Pelvic support hip reconstruction with exclusive internal devices is a technique in evolution with encouraging early results. It avoids common complications of external fixators and facilitates quick rehabilitation of joints. Refraining from distal varus can effectively eliminate Trendelenburg gait, albeit with some degree of lateral mechanical axis deviation. Unlike external fixation where there is a possibility of gradual correction, this staged procedure of internal fixation is technically demanding with a learning curve. Clinical significance: Pelvic support hip reconstruction performed by internal implants is a viable alternative to IHR with potential benefits.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 Jaypee Brothers Medical Publishers Ltd. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
Keywords: | Ilizarov hip reconstruction; Internal lengthening nail; Limb lengthening; Pelvic support osteotomy |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 28 Jul 2021 13:45 |
Last Modified: | 30 Jul 2021 09:22 |
Published Version: | https://www.stlrjournal.com/abstractArticleContent... |
Status: | Published |
Publisher: | Jaypee Brothers Medical Publishing |
Refereed: | Yes |
Identification Number: | 10.5005/jp-journals-10080-1459 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:176610 |