Hip fusion through an anterior approach with the use of a ventral plate.
A new technique to achieve a reliable fusion of the hip joint through an anterior approach with use of a ventral low contact dynamic compression plate and a lateral 6.5 mm lag screw is presented in detail. The advantages of this technique are that the approach does not jeopardize the vascularity of the femoral head, that the fixation on the pelvic side uses the strong bone stock of the sciatic buttress, and that the hip abductor muscles and greater trochanter are preserved. The authors also present the indications and the results of their experience with 12 patients. The followup period averaged 24.8 months (range, 10-42 months). Ten patients (83%) achieved a solid fusion by radiologic and clinical criteria. Although a moderately symptomatic nonunion developed in 1 patient, another patient went on to a painful nonunion to whom another attempt for fusion has been recommended. According to the hip score of Merle d'Aubigné and Postel, the average figures for pain and ambulation increased from 3.2 points to 5.0 points and from 2.7 points to 4.5 points, respectively, after surgery. Six of the 12 patients regained the ability to work in their former jobs or in new occupations. Eight patients felt no or minor restrictions in doing their former sports activities. Patient satisfaction was high with a majority reporting minor discomfort mainly around the fused hip.
Matta
J M
JM
Department of Clinical Orthopaedics, Good Samaritan Hospital, University of Southern California, Los Angeles, USA.
Siebenrock
K A
KA
Gautier
E
E
Mehne
D
D
Ganz
R
R
D000203:Activities of Daily Living; D000328:Adult; D001174:Arthrodesis / Q000295:instrumentation*; D001860:Bone Plates; D005270:Femur Head / Q000098:blood supply; D005500:Follow-Up Studies; D005684:Gait; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008124:Locomotion; D008297:Male; D011859:Radiography