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Ilizarov hip reconstruction in skeletally mature young patients with chronic unstable hip joints

  • Orthopaedic Surgery
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Abstract

Purpose

Hip reconstruction with subtrochanteric valgus extension pelvic support osteotomy and distal femoral osteotomy for lengthening and varus correction is one of the options available for salvage of chronic unstable hips and is also known as Ilizarov hip reconstruction (IHR). This study evaluated the outcomes and complications associated with IHR in skeletally mature young patients.

Methods

Twelve patients (7 males, 5 females) with a mean age of 23 years underwent IHR for chronically dislocated hips due to various causes. Preoperative clinical and radiological evaluations were used to determine the site of osteotomies and the required angulations. Postoperatively the patients were followed up clinically and radiologically for a minimum of 36 months. Ilizarov fixator was removed when adequate lengthening was achieved and there was radiological evidence of union. Harris Hip Score was used to document hip function preoperatively and at final evaluation.

Results

Significant improvements occurred in limb length discrepancy (LLD) 5.11 cm preoperatively to 0.9 cm at final evaluation, Harris Hip Score 44.33 points preoperatively to 70.83 points (p < 0.0001) at final evaluation. Trendelenberg sign disappeared completely in nine patients and was delayed in three at final evaluation. The abduction at the hip increased from the preoperative mean of 12.08° (range 0°–25°) to 22.5° (range 15°–35°) postoperatively. The fixed flexion deformity at the hip decreased from 22° (range 10°–35°) preoperatively to 3° postoperatively (range 0°–10°). The amount of free flexion at the operated hips decreased from the preoperative mean of 88.33° (range 70°–120°) to 70.42° (range 45°–105°) at final follow up. The mean fixator interval was 7.33 months (5–12 months) and the mean follow up duration was 59.4 months (38–86 months).

Conclusions

IHR is effective in improving the hip biomechanics, correcting the LLD and eliminating the Trendelenberg sign. Lengthy period of fixator wear, knee stiffness and pin tract infections, though minor are known limitations of this procedure.

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Authors and Affiliations

  1. All India Institute of Medical Sciences, 251 Type III Quarters, Ayur Vigyan Nagar, August Kranti Marg, New Delhi, 110049, India

    Kanniraj Marimuthu

  2. Sawai Man Singh Medical College, Jaipur, India

    Narendra Joshi, Chandra Sekar Sharma, Rakesh Bhargava, Devi Sahai Meena, Ramesh Chandra Bansiwal & Ramachandran Govindasamy

Authors
  1. Kanniraj Marimuthu
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  2. Narendra Joshi
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  3. Chandra Sekar Sharma
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  4. Rakesh Bhargava
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  5. Devi Sahai Meena
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  6. Ramesh Chandra Bansiwal
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  7. Ramachandran Govindasamy
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Correspondence to Kanniraj Marimuthu.

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Marimuthu, K., Joshi, N., Sharma, C.S. et al. Ilizarov hip reconstruction in skeletally mature young patients with chronic unstable hip joints. Arch Orthop Trauma Surg 131, 1631–1637 (2011). https://doi.org/10.1007/s00402-011-1376-4

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  • DOI: https://doi.org/10.1007/s00402-011-1376-4

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