MONTGOMERY HIP SCREW: THE EARLY CLINICAL RESULTS IN PROXIMAL FEMORAL OSTEOTOMIES

Abstract

Background: Aim of the study was to evaluate the clinical results of Montgomery Hip Screw for fixation of proximal femoral osteotomies. There are a number of devices for proximal femoral fixation, including sliding hip screws. Rotational instability of the proximal femoral segment can be a problem. To overcome this, a hip screw has been introduced with two screws in the proximal segment.

Methods and Results: A prospective cohort undergoing osteotomy was followed up. Inclusion criteria included consecutive patients < 16 years of age, with an indication for elective proximal femoral osteotomy. All operations were performed by senior author or under his supervision using a standard postero-lateral approach. Further incisions for adductor/psoas release and pelvic osteotomy were added as indicated. In 23 cases MHS was used with a mean follow up of 10 months (6 to 24). In 9 patients there was an underlying neurological problem, one case of LCPD, and the rest had DDH. Previous surgery with a hip screw on the contralateral side had been undertaken in 5 cases. The mean age was 5 years (range 1 to 12) and mean time to union was 6.3 weeks. There were no occurrences of rotational instability or failure of fixation. No wound complication was encountered in the cohort.

Conclusions: Early results indicate that Montgomery Hip Screw is a safe device for fixation of proximal femoral osteotomy with the added advantage of rotational stability.