Author/Authors :
Demétrio de Sousa Pontes, Mariana Universidade de São Paulo, Hospital das Clínicas - Ribeirão Preto Medical School - Department of Orthopedics and Anesthesiology, Ribeirão Preto, SP, Brazil , Henrique Bortolin, Paulo Universidade de São Paulo, Hospital das Clínicas - Ribeirão Preto Medical School - Department of Orthopedics and Anesthesiology, Ribeirão Preto, SP, Brazil , Batista Volpon, José Universidade de São Paulo, Hospital das Clínicas - Ribeirão Preto Medical School - Department of Orthopedics and Anesthesiology, Ribeirão Preto, SP, Brazil
Abstract :
Objective: To evaluate the results of double femoral osteotomy for the
treatment of severe sequelae of the hip. Methods: Immature patients
with anatomical loss of the hip were treated with pelvic support
osteotomy in the distal femur to correct lower limb shortening, they
were evaluated clinically and radiographically. Results: Eleven cases
(eleven hips) were assessed with verage follow-up of three years.
The mean age of the patients was 14.7 years. Seven patients had
sequela of infectious arthritis; three had sequela of developmental
dysplasia of the hip and one patient had a sequela of slipped capital
femoral epiphysis. Preoperatively, the gluteus medius was insufficient
in all patients, and it became negative in ten of them. The average of
lower limb shortening was 5 cm (2.5 to 7 cm) and reduced shortening
was 1.9 cm (0 to 4 cm). According to Paley Classification, 72.7% of
complications were considered problems, 90.9% were considered
obstacles and 27.2% complications, among which the limitation of
the knee flexion was the most frequent. Conclusion: The technique
yielded good results, considering the severity of the sequela and the
absence of a better therapeutic option. No important sequela was
associated with the treatment. Level of Evidence IV, Case series.
Keywords :
Hip Joint , Hip Dislocation , Osteotomy , Arthritis , Infectious