Hip reconstruction for femoral head loss from septic arthritis in children. A preliminary report.
Seven children (8 hips) with Choi's Type IV-B sequelae of septic arthritis of the hip underwent an unconventional reconstruction technique using a vascular-pedicled iliac crest graft to replace the destroyed femoral head and neck. The average age at surgery was 3.5 years, and the mean followup 7 years. Graft incorporation was observed in all patients; however, severe graft resorption was found in 1 hip, and mild resorption in 4 hips. The method of internal fixation of the iliac crest graft was not ideal and will require modification. Excellent femoral head-neck substitution with graft hypertrophy and remodeling was seen in 3 hips. In 7 hips (88%), vertical hip stability was achieved and a good range of hip motion was maintained. All children adapted very well to the operative procedures. At the final followup, the symptoms were those of limb-length discrepancy; pain was not a symptom.
Cheng
J C
JC
Department of Orthopaedics and Traumatology, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin.
Aguilar
J
J
Leung
P C
PC
D001170:Arthritis, Infectious / Q000150:complications / Q000601:surgery*; D001862:Bone Resorption / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D005260:Female; D005270:Femur Head / Q000601:surgery*; D005272:Femur Neck / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007870:Leg Length Inequality / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D016896:Treatment Outcome