Hip arthrodesis with the dynamic hip screw.
The authors report a series of 10 patients (4 male, 6 female) with end-stage hip degeneration who underwent unilateral hip arthrodesis at an average age of 19 years (range 14-35). Surgery was performed with the patient in the supine position through a Watson-Jones approach and fixation was stabilized with the AO Dynamic Hip Screw (DHS). After surgery, patients were mobilized in a short hip spica. Stable fixation with the DHS could not be achieved at surgery in one patient. Bony union was achieved in seven of the nine patients (78%) with a DHS after an average of 17 weeks (range 9-34). In one patient a painful nonunion developed; it was converted to a total hip arthroplasty 23 months later. Another patient obtained a painless pseudarthrosis, for which no further surgery is planned. The DHS provides a satisfactory means of stabilizing a hip arthrodesis when combined with a hip spica. This method of arthrodesis does not violate the origin or insertion of the abductor mechanism, thereby facilitating future conversion to total hip arthroplasty.
Bankes
Marcus J K
MJ
Department of Pediatric Orthopaedics, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, United Kingdom. marcus@bankes.org.uk
Simmons
Jon M H
JM
Catterall
Anthony
A
D000293:Adolescent; D000328:Adult; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome