Subtrochanteric Femoral Shortening Oblique Osteotomy in High Dislocation of the Hip with Total Hip Arthroplasty: A Case Report

Dwarfism is a condition of extreme short stature. Total hip arthroplasty (THA) in patients with dwarfism is a very demanding procedure due to their specific joint deformity and small bone size, which increases the technical difficulty of the THA procedure in such patients with hip dysplasia. This current case report describes a 29-year-old female patient that was admitted due to shortening of the right lower limb, as compared with the contralateral side, which had been present for 18 years. She also complained of pain in the right hip that had been present for 2 months. The hip pain was aggravated by physical exertion, but relieved by rest. She had pituitary dwarfism without mental retardation or delayed sexual development and Crowe type IV dysplasia of the right hip. A THA combined with femoral shortening osteotomy was undertaken, which resolved the pain symptoms and improved her ability to undertake activities of daily living such as walking without pain. Dwarfism with hip dysplasia is a rare but extremely challenging problem that can be successfully treated with THA combined with femoral shortening osteotomy using an S-ROM stem.

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Central fracture dislocation of the hip associated with fracture of femoral neck treated by femoral head autograft and total hip arthroplasty: A rare case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2020.11.148 ◽

2021 ◽

Vol 78 ◽

pp. 90-95

Author(s):

Wayan Suryanto Dusak ◽

Cokorda Gde Oka Dharmayuda ◽

Ketut Siki Kawiyana ◽

Richard Afandi ◽

Gede Ketut Alit Satria Nugraha

Keyword(s):

Case Report ◽

Femoral Head ◽

Total Hip Arthroplasty ◽

Femoral Neck ◽

Hip Arthroplasty ◽

Rare Case ◽

Fracture Dislocation ◽

Total Hip ◽

Rare Case Report ◽

Dislocation Of The Hip

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An oblique osteotomy is better for subtrochanteric shortening in total hip arthroplasty for high hip dislocation: a mechanical comparison of four techniques

Hip International ◽

10.1177/1120700020957990 ◽

2020 ◽

pp. 112070002095799

Author(s):

Dogan Atlihan ◽

Cem Yildirim ◽

Osman Gorkem Muratoglu ◽

Duran Can Muslu ◽

Mazhar Tokgözoğlu ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Stem ◽

Hip Dislocation ◽

Developmental Dysplasia ◽

Torsional Stiffness ◽

Test Model ◽

Total Hip ◽

Oblique Osteotomy ◽

Femoral Shortening

Background: Subtrochanteric femoral shortening is used during total hip arthroplasty for high hip dislocation in developmental dysplasia of hip patients. Methods: We mechanically tested the stability of various commonly used subtrochanteric osteotomy techniques. As the equivalent of a femoral stem placed in a shortened femur without any stable fixation at the osteotomy line, 2 polyvinylchloride pipes were loosely intertwined. 4 different osteotomies (Z-subtrochanteric osteotomy, oblique-45° osteotomy, double Chevron-90° and 120° subtrochanteric osteotomy) were simulated. Torsional and axial loads were applied, and torsional stiffness was calculated for each test model. Results: Z, double Chevron-90° and 120° subtrochanteric osteotomy models demonstrated lower mean torsional stiffness than oblique-45° osteotomy. With the highest torsional stiffness oblique-45° provides the best stability for treatment of high dislocation hips when a subtrochanteric osteotomy is added. Conclusions: This matches our previous clinical experience. Oblique osteotomy may also provide higher contact surfaces in the osteotomy lines to promote bone healing.

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