Avascular necrosis of the femoral head in sickle-cell disease: restoration of sphericity and congruency following triple pelvic osteotomy. A case report.
A 9-year-old boy, originally from Zaire, presented with homozygous sickle-cell disease and a unilateral avascular necrosis of the femoral head. He was treated with a triple pelvic osteotomy to improve containment and stimulate remodelling of the head following prior partial reduction in a spica cast. Four and a half years postoperatively the patient was pain free with normal hip function. Radiography revealed a well-centred hip with a mild coxa magna and a nearly spherical femoral head. In geographic regions with a small black population, sickle cell disease and related orthopaedic problems are rarely encountered, but one must be prepared for the occasional patient. Triple pelvic osteotomy for the treatment of femoral head necrosis associated with sickle cell disease has not yet been reported and has led in this case to a highly satisfying improvement of the hip.
Ziegler
Dirk
D
Department of Orthopaedics, University of Zürich, Zürich, Switzerland.
Ulrich Exner
G
G
D000755:Anemia, Sickle Cell / Q000150:complications*; D002648:Child; D015023:Democratic Republic of the Congo; D004641:Emigration and Immigration; D005271:Femur Head Necrosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D010027:Osteotomy / Q000379:methods*; D010384:Pelvic Bones / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D013557:Switzerland; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome