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Limb Lengthening Center Munich
Professor Baumgart, MD

Hip dislocation

Clinical Condition

A 28-year-old female patient with undiagnosed hip dysplasia (inadequate femoral head covering) 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. An alternative to a detrimental hip joint fusion was an artificial hip joint despite her young age, in order to achieve freedom from pain and restore mobility.

Shortened leg with hip dislocation

Shortened leg with hip dislocation

The femoral head was dislocated proximally

The femoral head was dislocated proximally

Treatment

During the first stage of treatment, the artificial socket 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 shaft of the artificial hip joint was implanted.

Before starting distraction

Before starting distraction

After completion of lengthening

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

Treatment result with equal length legs

Artificial hip joint right in the anatomically correct position

Artificial hip joint right in the anatomically correct position

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