title: Dislocation and subluxation during femoral lengthening.
abstract: Femoral lengthening by callus distraction was performed on 26 femurs of 18 patients with various disorders between 1988 and 1992. Age at surgery ranged from 6 to 17 years (13 years on average). The amount of lengthening varied from 2 to 7.5 cm (mean 5 cm). Follow-up evaluation of femoral-head displacement was based on the change of center-edge (CE) angle. The hips were divided into two groups based on the preoperative CE angle; one group consisted of 14 hips with a CE angle > 20 degrees and the other group consisted of 12 hips with an angle of < or = 20 degrees. In the first group, none of the hips deteriorated; however, five of 12 hips in the second group did deteriorate. One hip developed complete dislocation and the other four showed a decrease in the CE angle. Four of five deteriorated hips had a history of congenital dislocation of the hip and the other had multiple epiphyseal dysplasia. In cases in which the CE angle is < or = 20 degrees preoperatively, bony procedures such as innominate osteotomy should precede femoral elongation.
authors.affiliation: Department of Orthopedics, Shiga Medical Center for Children, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Kasahara
authors.forename: Y
authors.initials: Y
authors.lastname: Seto
authors.forename: T
authors.initials: T
authors.lastname: Futami
authors.forename: K
authors.initials: K
authors.lastname: Furukawa
authors.forename: Y
authors.initials: Y
authors.lastname: Nishino
mesh_terms: D000293:Adolescent; D001852:Bone Lengthening / Q000379:methods; D002648:Child; D005260:Female; D005269:Femur / Q000601:surgery*; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006618:Hip Dislocation, Congenital / Q000503:physiopathology; D006801:Humans; D007870:Leg Length Inequality / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011859:Radiography