Iliofemoral distraction and hip reconstruction for the sequelae of a septic dislocated hip with chronic femoral osteomyelitis.
We describe a technique of 'cross-hip distraction' to reduce a dislocated hip with subsequent reconstruction of the joint for septic arthritis with extensive femoral osteomyelitis. A 27-year-old woman presented with a dislocated, collapsed femoral head and chronic osteomyelitis of the femur. Examination revealed a leg-length discrepancy of 7 cm and an irritable hip. A staged technique was used with primary clearance of osteomyelitis and secondary reconstruction of the hip. A cross-hip monolateral external fixator was used to establish normal anatomy followed by an arthroplasty. A good functional outcome was achieved. The use of cross-hip distraction avoids soft-tissue and nerve damage and achieved improved abductor function before arthroplasty.
Nagarajah
K
K
Nuffield Orthopaedic Centre, Headington, Oxford OX3 7LD, UK. Kugan@doctors.org.uk
Aslam
N
N
McLardy Smith
P
P
McNally
M
M
D000328:Adult; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000601:surgery; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D019857:Osteogenesis, Distraction / Q000379:methods*; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography