Abstract
Aim: To report our experience and early results with the Ilizarov pelvic support realignment lengthening osteotomy for complex hip pathology in children.
Material & Methods: Between 1997 & 2004, seven children were treated with this technique and five have completed treatment. The treatment was undertaken for sequelae of DDH in 4 patients and septic arthritis in 1 patient. The median age of the patients was 13(10–17). There were 3 boys and 2 girls. The outcome assessment was performed using the Harris hip score, clinical and radiological parameters.
Results: 4 patients presented with hip instability, shortening of the lower limb, pain and restricted motion. The remaining patient presented with a nonfunctional ankylosis with shortening. The median time between the onset of symptoms and the operation was 3 years (2–5). The median preoperative leg-length discrepancy was 3 cm (2–4.5). The median fixator time was 5 months (3–6). The median follow-up was 24 months (9–72).
Patients had improvement of pain, posture, hip instability, walking ability and limb length discrepancy. The median lengthening of the femur was 3 cm (2–5). The mechanical axis was realigned in all patients. All patients were satisfied with the outcome. Planned secondary contra lateral epiphyseodesis was required to equalise leg length in 2 patients. Complications included a stiff knee (1) that required a Judet quadricepsplasty, premature consolidation (1) that required reosteotomy and knee subluxation (1) that required cross knee stabilisation.
Conclusion: This is a safe and reliable alternative option to joint replacement, Colonna arthroplasty and arthrodesis for the reconstruction of multiply operated complex hip pathology in children.
Mr James Robb – BSCOS Honorary Secretary, Mr Geoffrey Mill – Host of the meeting, Mr Robin Paton – Editorial Secretary. Correspondence should be sent to BSCOS, c/o Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London, WC2A 3PN.
