Pelvic support osteotomy by Ilizarov's concept: Is it a valuable option in managing neglected hip problems in adolescents and young adults?
Mahmoud A. Mahran, Mohamed A. ElGebeily, Nabil A. M. Ghaly, Mootaz F. Thakeb, Hany M. Hefny
Keywords :
Pelvic support osteotomy, Hip osteotomy, Femoral reconstruction osteotomy, Neglected hip dislocation, Pelvic support femoral reconstruction, Neglected hip problems in pediatric age group, Ilizarov hip reconstruction
Citation Information :
Mahran MA, ElGebeily MA, Ghaly NA, Thakeb MF, Hefny HM. Pelvic support osteotomy by Ilizarov's concept: Is it a valuable option in managing neglected hip problems in adolescents and young adults?. 2011; 6 (1):13-20.
For evaluating pelvic support osteotomy as a salvage procedure in managing neglected hip problems in adolescents and young adults, PSO was performed for 20 hips in 20 patients (5 men and 15 women). The mean age was 21.5 years. The etiology was neglected developmental dysplasia of the hip in 9 patients, post-septic hip sequelae in 9 patients, and paralytic dislocation due to poliomyelitis in 2 patients. All patients were treated by two osteotomies: a proximal femoral osteotomy to support the pelvis and correct the flexion and rotational deformities of the hip and a distal varization and lengthening osteotomy. Final clinical evaluation was done 6 months after frame removal. The mean external fixation time was 6.4. Lengthening and mechanical axis parallelism was achieved in all patients. At the final follow-up and according to a predesigned scoring system, there were 7(35%) excellent results, 6(30%) good results, 7(35%) fair results, and no poor results. Hip reconstruction by Ilizarov's concept can be technically demanding and involving lengthy period wearing the frame but found to be a valuable salvage procedure for numerous neglected hip problems particularly in young patients.
Callaghan JJ, Brand RA, Pedersen DR (1985) Hip arthrodesis. A long-term follow-up. J Bone Joint Surg Am 67(9):1328-1335
Maiocchi A (ed) (1994) Treatment of disorders of the hip. Special techniques. Il quadratino, Milan
Rozbruch S, Paley D, Behave A, Herzenberg J (2005) Ilizarov hip reconstruction for the late sequelae of infantile hip infection. J Bone Joint Surg Am 87A:1007-1018
Kocaoglu M, Eralp L, Sen C, Dincyurek H (2002) The Ilizarov hip reconstruction osteotomy for hip dislocation: outcome after 4-7 years in 14 young patients. Acta Orthop Scand 73(4):432-438
Bombelli R (ed) (1993) Structure and function in normal and abnormal hips: How To Rescue Mechanically Jeopardized Hips, 3th edn. Springer, Berlin
Manzotti A, Rovetta L, Pullen C (2003) Treatment of late sequelae of septic arthritis of the hip. Clin Orthop Relat Res 410:203-212
Stack JK, George K (1959) Pelvic support osteotomy for certain fracture complications of the hip. Am J Surg 97(5):644-648
Kirmission E (1894) De' l'osteotomie sous-trochante'rienne applique'e a certains cas de luxation conge'nitale de la hanche. (flexion de la cuisse avec adduction conside'rable). Rev d'Orthop 137
Shepherd MM (1960) A further review of the results of operations on the hip joint. J Bone Joint Surg Br 42B:177-204
Lorenz A (1919) Ueber die Behandlung der irreponiblen angeborenen Huftluxationen und der Schenkelhalspseudoarthrosen mittels Gabelung (Bifurkation des oberen Femurendes). Wien Klin Wchnschr. XXXII
Maiocchi A, Aronson J (eds) (1992) Treatment of disorders of the hip. Williams and Wilkins, Baltimore
Paley D (ed) (2002) Hip joint considerations. Springer, Berlin
MacKenzie JR, Kelley SS, Johnston RC (1996) Total hip replacement for coxarthrosis secondary to congenital dysplasia and dislocation of the hip Long-term results. J Bone Joint Surg Am 78(1):55-61
Milch H (1989) The “pelvic support” osteotomy. 1941. Clin Orthop Relat Res 249:4-11
Gaenslen F (1935) The schanz subtrochanteric osteotomy for irreducible dislocation of the hip. J Bone Joint Surg Am 17:76-78
