title: Femoral shortening and cementless arthroplasty in Crowe type 4 congenital dislocation of the hip.
abstract: OBJECTIVE
  In reconstruction of congenital hip dislocation by total hip arthroplasty (THA), positioning of the acetabular component in the true acetabulum is sometimes accompanied by shortening of the femur. Shortening of the femur is of importance for minimising risk of damaging neurovascular structures due to excessive limb lengthening. Furthermore, reduction of the femoral head into the true acetabulum remains challenging without shortening of the femur.
  
  
  METHODS
  We performed a consecutive case series of cementless THA with femoral shortening and Crowe type 4 congenital dislocation. All acetabular cups were placed in their original anatomical location. In all cases a proximal diaphyseal step-cut shortening osteotomy was performed and stabilised with two to three titanium cerclage bands.
  
  
  RESULTS
  At an average of 60 months follow-up (range 36-96), 12 patients (13 THA) were scored clinically by the Merle D'Aubigne and Harris hip scores. In ten cases good to excellent outcome scores were observed. During the follow-up period no cases of aseptic loosening, nerve palsy, nonunions or dislocations were found.
  
  
  CONCLUSIONS
  This technique seems to be an excellent treatment option in the case of Crowe type 4 hips presenting with endstage osteoarthritis.
authors.affiliation: PMU Salzburg, Orthopedic University Clinic, Salzburg, Austria. dr.daniel.neumann@gmail.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Neumann
authors.forename: Christoph
authors.initials: C
authors.lastname: Thaler
authors.forename: Ulrich
authors.initials: U
authors.lastname: Dorn
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001843:Bone Cements; D002484:Cementation; D004185:Disability Evaluation; D005260:Female; D005269:Femur / Q000473:pathology* / Q000601:surgery; D006304:Health Status; D006618:Hip Dislocation, Congenital / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D011183:Postoperative Complications; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001843:Bone Cements