External fixation-assisted reduction for the treatment of neglected hip dislocations with limb length discrepancy: a retrospective study of 13 cases

Abstract Background The purpose of this study was to evaluate a new method for treating neglected hip dislocation with limb length discrepancy by using external fixation-assisted pre-reduction. Methods Thirteen patients admitted between January 2010 to February 2018 with a mean duration from injury to surgery of 5.0 ± 2.1 months and an average preoperative leg-length discrepancy of 7.7 ± 2.3 cm were enrolled in this study. The dislocation and associated acetabular fracture type, clinical outcomes and residual limb length discrepancy were evaluated. Results All patients had posterior dislocations, and nine patients presented with acetabular fractures and were followed-up for at least 12 months. The average traction duration of external fixators was 28.8 ± 8.0 days and all patients received second-stage open reduction and internal fixation. Six patients showed residual limb length discrepancy within 2 cm. Patients showed significant improvement in hip function and pain relief. Complications including avascular femoral head necrosis and osteoarthritis occurred in three patients. Conclusion Effective correction of limb length discrepancy and improved function were observed in patients with neglected hip dislocations and limb equality using traction by external fixation combined with second-stage open reduction. Further follow-up is required to determine long-term outcomes.

Download Full-text

External fixation-assisted reduction for the treatment of neglected hip dislocations with limb length discrepancy: a retrospective study of 13 cases.

10.21203/rs.2.11301/v3 ◽

2019 ◽

Author(s):

Pengyu Li ◽

Wenhao Song ◽

Jinlei Dong ◽

Daodi Qiu ◽

Dongsheng Zhou

Keyword(s):

External Fixation ◽

Open Reduction ◽

Hip Dislocation ◽

Limb Length Discrepancy ◽

Limb Length ◽

Acetabular Fractures ◽

External Fixators ◽

Residual Limb ◽

Second Stage ◽

Length Discrepancy

Abstract Background: The purpose of this study was to evaluate a new method for treating neglected hip dislocation with limb length discrepancy by using external fixation-assisted pre-reduction. Methods: Thirteen patients admitted between January 2010 to February 2018 with a mean duration from injury to surgery of 5.0±2.1 months and an average preoperative leg-length discrepancy of 7.7±2.3 cm were enrolled in this study. The dislocation and associated acetabular fracture type, clinical outcomes and residual limb equality were evaluated. Results: All patients had posterior dislocations, and nine patients presented with acetabular fractures and were followed-up for at least 12 months. The average traction duration of external fixators was 28.8±8.0 days and all patients received second-stage open reduction and internal fixation. Six patients showed residual limb length discrepancy within 2 cm. Patients showed significant improvement in hip function and pain relief. Complications including avascular femoral head necrosis and osteoarthritis occurred in three patients. Conclusion: Effective correction of limb length discrepancy and improved function were observed in patients with neglected hip dislocations and limb equality using traction by external fixation combined with second-stage open reduction. Further follow-up is required to determine long-term outcomes. Keywords: neglected hip dislocation, limb length discrepancy, external fixatio

Download Full-text

External fixation assisted reduction in the treatment for obsolete hip dislocations with limb discrepancy

10.21203/rs.2.11301/v1 ◽

2019 ◽

Author(s):

Pengyu Li ◽

Wenhao Song ◽

Jinlei Dong ◽

Daodi Qiu ◽

Dongsheng Zhou

Keyword(s):

External Fixation ◽

Open Reduction ◽

Acetabular Fractures ◽

External Fixators ◽

Residual Limb ◽

Leg Length ◽

Second Stage ◽

Reduction Methods ◽

Hip Function ◽

Improved Function

Abstract Abstract Background: The purpose of this study is to evaluate a new method for treating obsolete acetabular dislocation with limb discrepancy by external fixation assisted pre-reduction. Methods: Thirteen patients admitted from January 2010 to February 2018 with a mean duration from injury to surgery of 5.0±2.1 months and an average preoperative leg-length discrepancy of 7.7±2.3 cm were enrolled in this study. The dislocation and associated acetabular fracture type, clinical outcomes and residual limb equality were evaluated. Results: All patients were posterior dislocations and nine presented with acetabular fractures and were followed-up at least 12 months. The average traction duration of external fixators was 28.8±8.0 days and all patients received second-stage open reduction and internal fixation. Six patients showed residual limb discrepancy within 2 cm. Patients showed significant improvement in hip function and pain relief. Complications including avascular femoral head necrosis and osteoarthritis occurred in 3 patients. Conclusion: Effective correction of limb discrepancy and improved function showed in patients with obsolete acetabular dislocations and limb equality using traction by external fixation combined with second-stage open reduction. The long-term outcomes need continued follow-up.

Download Full-text

External fixation-assisted reduction for the treatment of neglected hip dislocations with limb discrepancy: a retrospective study of 13 cases.

10.21203/rs.2.11301/v2 ◽

2019 ◽

Author(s):

Pengyu Li ◽

Wenhao Song ◽

Jinlei Dong ◽

Daodi Qiu ◽

Dongsheng Zhou

Keyword(s):

External Fixation ◽

Open Reduction ◽

Acetabular Fractures ◽

External Fixators ◽

Residual Limb ◽

Leg Length ◽

Second Stage ◽

Reduction Methods ◽

Hip Function ◽

Improved Function

Download Full-text

An alternative treatment method to restore limb-length discrepancy in osteoarthritis with high congenital hip dislocation

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-009-0846-4 ◽

2009 ◽

Vol 129 (12) ◽

pp. 1593-1599 ◽

Cited By ~ 7

Author(s):

Matthias Lerch ◽

F. Thorey ◽

G. von Lewinski ◽

P. Klages ◽

C. J. Wirth ◽

...

Keyword(s):

Alternative Treatment ◽

Hip Dislocation ◽

Limb Length Discrepancy ◽

Treatment Method ◽

Limb Length ◽

Congenital Hip Dislocation ◽

Length Discrepancy

Download Full-text

Intramedullary Bone Lengthening Following Preceding Hip Surgery—A Case Series

Journal of Clinical Medicine ◽

10.3390/jcm9124104 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4104

Author(s):

Lukas Zak ◽

Thomas Manfred Tiefenboeck ◽

Gerald Eliot Wozasek

Keyword(s):

Hip Dysplasia ◽

Young Patients ◽

Limb Lengthening ◽

Limb Length Discrepancy ◽

Limb Length ◽

Hip Surgery ◽

Bone Lengthening ◽

Safe Procedure ◽

Length Discrepancy ◽

Healing Index

Limb length discrepancy (LLD) is a common problem after joint-preserving hip surgeries, hip dysplasia, and hip deformities. Limping, pain, sciatica, paresthesia, and hip instability are common clinical findings and may necessitate limb-lengthening procedures. The study included five patients (two female and three male, mean age of 28 years (20–49; SD: 12)) with symptomatic limb length discrepancy greater than 2.5 cm (mean: 3.6 cm) after total hip arthroplasty (THA), hip dysplasia, or post-traumatic hip surgery. They underwent either ipsi- or contralateral intramedullary limb-lengthening surgeries using the PRECICE™ telescopic nail. All patients achieved complete bone healing and correction of the pelvic obliquity after intramedullary lengthening. None of the patients had a loss of proximal or distal joint motion. The mean distraction-consolidation time (DCT) was 3.8 months, the distraction index (DI) 0.7 mm/day, the lengthening index (LI) 1.8 months/cm, the consolidation index (CI) 49.2 days/cm, the healing index (HI) 1.1 months/cm, and the modified healing index (HI*) 34 days/cm. Intramedullary limb lengthening after LLD in cases of hip dysplasia, hip deformity, and various kinds of hip surgery is a useful and safe procedure in young patients to achieve equal limb length. No functional impairment of the preceded hip surgery was seen.

Download Full-text