Professor Baumgart, MD
Limb Lengthening Center Munich
Hip dislocation
Clinical history
A 28-year-old female patient with undiagnosed hip dysplasia (inadequate coverage of the femoral head) had a shortened leg because the femoral head had migrated upwards over time (high hip dislocation). In addition to the shortening of 3 cm, abduction was limited, and the patient was experiencing increasing pain, so that walking was hardly possible. Despite her young age, the only alternative to a detrimental hip fusion (arthrodesis) for achieving freedom from pain and mobility was an artificial hip joint.
Shortened leg with hip dislocation
The femoral head was dislocated proximally
Treatment
During the first stage of treatment, the artificial acetabular cup was implanted in the correct position at the same height as the opposite side. A FITBONE intramedullary distraction nail was inserted into the femur and hinged to a new type of pelvic support plate. After discharge from hospital, the patient underwent continuous soft tissue stretching for 6 weeks so that the sensitive sciatic nerve could also slowly stretch, without injury. When the femur had reached the correct position, the second stage of treatment was carried out: the distraction nail was removed and the stem of the artificial hip joint was implanted.
Before starting distraction
After completion of lengthening
Result
After the treatment, the affected hip joint was in an anatomically-correct position for the first time, with almost normal flexibility. In addition, her leg lengths were equal, and she was able to walk without pain. Both hip and knee joints were at same level, which is crucial for a normal gait pattern. Such treatment could previously only be carried out with external fixators, which created a significant risk of infection, especially in the area of the artificial hip joint.
Treatment result with equal length legs
Artificial hip joint right in the anatomically correct position
More information
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