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Articulated Hip Joint Distraction

  • Dan S. Epstein
  • Reggie C. Hamdy
Chapter

Abstract

Perthes disease can lead to severe sequelae, especially with late-onset disease, severe collapse of the lateral pillar (Herring type C), and extrusion of the femoral head. A severely deformed, collapsed, and subluxated femoral head may lead to pain, stiffness, and limited function of the patient. At that advanced stage of the disease, only a few salvage procedures are possible, including hip fusion and hip arthroplasty. Articulated hip distraction is an alternative to both these procedures and may delay the need for either hip fusion or joint arthroplasty. This is the case of a 10-year-old boy who presented with Herring type C Perthes of his left hip. He had increasing hip pain, stiffness, and inability to perform most of his daily activities. He successfully underwent articulated hip distraction with a monolateral fixator. The fixator was kept for 4 months, during which time the patient was partially weight bearing. Intensive supervised physiotherapy maintained a satisfactory range of hip flexion of 90°. The pain was relieved. Following removal of the fixator, he continued the intense physiotherapy and maintained a brace at night for another 3 months. Two years post removal of the fixator, he remained pain-free and maintained a satisfactory range of motion of his hip with abduction of 20° and flexion of 130°. He continued his normal daily activities.

Keywords

Articulated hip joint distraction External fixator Salvage procedure 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.McGill UniversityMontrealCanada
  2. 2.Shriners Hospital for Children – CanadaMontrealCanada
  3. 3.Division of Orthopaedic SurgeryMcGill University Health CentreMontrealCanada
  4. 4.The Montreal Children’s HospitalMontrealCanada

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