Purpose: A modification of the arthrodesis as described by F R Thompson is reviewed in ten children. Method: Between September 1997 and July 2001, six patients ranging from 6 to 13 years underwent hip arthrodesis. Indications included trauma (one), idiopathic chondrolysis (one) post-septic arthritis (four) and tuberculosis of the hip joint (four). The subtrochanteric osteotomy was performed as a coronal chevron, differing from the previously described techniques. Patients were immobilized in a spica (six) and external fixation (four) in a functional position of 20 degrees flexion and neutral position (1degree abduction per year of growth left) for six weeks postoperatively. Conclusion: This review re-establishes hip arthrodesis as an acceptable treatment for children with destroyed joints and intractable pain. The modification used provides an attractable alternative in preventing the displacement of the subtrochanteric osteotomy, but allows correct positioning of the limb. The use of the external fixation allows lengthening if needed.
Between September 1997 and April 2000 hip arthrodesis was performed on six patients, using a modification of the techniques described by F.R. Thompson. The ages of patients ranged from 11 to 13 years, and indications included trauma (one patient) post-septic arthritis (two patients) and tuberculosis of the hip joint (three patients). The subtrochanteric osteotomy was performed as a coronal chevron, differing from previously described techniques. Patients were immobilised in a spica in a functional position of 20° flexion and the zero position (1° abduction per year of growth left) for six weeks postoperatively. The follow-up period ranged from 16 to 40 months. Union was achieved within six weeks. All patients achieved a pain-free gait, with minimal signs of disability. We believe that hip arthrodesis is an acceptable way of treating children with destroyed joints and intractable pain. The modification we used prevents displacement of the sub-trochanteric osteotomy but allows correct positioning of the limb.
