Background
Neglected dislocation of the hip joint in young adults is a difficult problem. Patients with an unstable hip secondary to any aetiology usually have loss of bone from the proximal femur or shortening of the limb or both.
Objective
In the present study we report our results in the treatment of the neglected dislocation of the hip joint in young adults by pelvic support osteotomy using the Ilizarov method.
Patients and methods
From 2007 to 2014, 30 patients (20 women and 10 men) with neglected dislocation of the hip joint were treated in the Orthopaedic Department of Al-Azhar University Hospital, Damietta, Egypt. Their mean age was 22.5 years (range: 19–35 years). The main complaints were pain, leg length discrepancy, limping and limited abduction of the hip. All patients underwent valgus extension osteotomy in the proximal femur and distal femoral osteotomy for lengthening. The average follow-up ranged from 2 to 7 years.
Results
All hips were pain free at follow-up. The Trendelenburg sign became negative in 25 patients. There was no limb length discrepancy and alignments of the extremity were re-established. Five patients had a lurch gait. Valgus extension osteotomy provided stability of the hip joint and maintained some motion of the hip joint. By using the Ilizarov technique we could prevent the valgus effects created by the valgus extension osteotomy while achieving lengthening of the femur through distal osteotomy in the femur.
Conclusion
Pelvic support osteotomy with Ilizarov modification can provide an alternative to other techniques in managing patients having excision arthroplasty who are severely disabled as a result of abductor weakness, instability and limb length discrepancy.