Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 6:24:101257.
doi: 10.1016/j.artd.2023.101257. eCollection 2023 Dec.

Reduction of High Hip Dislocation With a Distraction Nail and Arthroplasty (Preliminary Results of a Novel Technique)

Rainer Baumgart  1 , Mark Dahl  2 , Stephan Horn  3 , Werner Plötz  3 , Tillman Baumgart  1 , Stewart Morrison  4
Affiliations

Reduction of High Hip Dislocation With a Distraction Nail and Arthroplasty (Preliminary Results of a Novel Technique)

Rainer Baumgart et al. Arthroplast Today. .

Abstract

A novel distraction technique is described for total hip arthroplasty in symptomatic high hip dislocation (Crowe IV) combining an intramedullary motorized lengthening nail with a pelvic support plate to gradually stretch hip soft tissues (distalization) and performing total hip arthroplasty with the cup in the primary acetabulum. Twelve patients (15 hips) were identified in a retrospective study via chart review. Medical records and radiographs were reviewed for details of the initial case parameters, surgical details, magnitude of distalization, duration of treatment, outcomes, and complications. Followed by an average of 67.4 mm of distalization, nearly anatomical cup placement, and equal leg length were achieved in all patients. During distalization, pain level was low with acceptable range of motion. One unplanned surgery and no complications with long-term sequelae occurred.

Keywords: Chronic hip dislocation; Distraction nail; Gradual distalization; High luxation of the hip; Total hip arthroplasty.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Proximal migration of the hip joint and adduction contracture.
Figure 2
Figure 2
Pelvic support plate (PSP).
Figure 3
Figure 3
Sequence of treatment (1. initial finding, 2. start of distalization 3. end of distalization, 4. THA).
Figure 4
Figure 4
PSP in place.
Figure 5
Figure 5
Thirthy-eight years, female (Case #10) sequence of distalization.
Figure 6
Figure 6
Fifty-three years, male (Case #5) before and after treatment.
Figure 7
Figure 7
Fifty-three years, male (Case #5) clinical result.
Figure 8
Figure 8
Physical and mental component summary before and after treatment.
See this image and copyright information in PMC

References

    1. Crowe J.F., Mani V.J., Ranawat C.S. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979;61:15–23. - PubMed
    1. Liu R.Y., Bai C.Y., Song Q.C., Dang X.Q., Wu Y.J., Wang K.Z. Partial greater trochanter osteotomy for hip reduction in total hip arthroplasty for high dislocated hip: a preliminary report. BMC Musculoskelet Disord. 2014;15:293. - PMC - PubMed
    1. Starker M., Bischof F., Lindenfeld T. Versorgung der hohen Hüftluxation (Crowe-IV-Hüfte) mit einer zementfreien Individualendoprothese und z-förmiger subtrochantärer Femurverkürzung. Zeitschrift fur Orthopadie und Unfallchirurgie. 2011;149:518–525. - PubMed
    1. Król R., Rojewski M., Kamiński A., Popławski T. Operative tactics and results of treatment of patients with coxarthrosis secondary to congenital high luxation of hip joints. Ortop Traumatol Rehabil. 2007;9:604–611. - PubMed
    1. Zeng W.N., Liu J.L., Wang F.Y., Zhang X., Fan H.Q., Chen G.X., et al. Total hip arthroplasty for patients with Crowe type IV developmental dysplasia of the hip: Ten years results. Int J Surg. 2017;42:17–21. - PubMed

LinkOut - more resources