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Affected patients often can have astonishingly good function at first, but the associated leg shortening, often 6-8 cm, is noticeable and can be disturbing. This is aggravated by the fact that there is usually also an inhibition of abduction, so that the leg, which is already shortened, has to be lifted so that walking is possible at all. This means that in addition to the anatomical shortening, there is also a functional shortening, both of which aggravate spinal curvature. In these cases of high hip dislocation, especially when the hip becomes increasingly painful, it is not possible to implant an artificial hip joint in the typical fashion. The artificial hip joint would have no stable fixation option in this much too high, non-anatomical position in the pelvis, and thus an extremely poor long-term prognosis. Acute intraoperative distraction of the hip is also not a feasible alternative, as this inevitably leads to nerve damage. Continuous hip distalization is thus the only physiological therapeutic approach. However, in the past, distalization of the hip was only feasible with external fixators, which carry a considerable risk of infection - a complication which can completely destroy the function of an artificial hip joint.",[],[324],"lg:col-span-6",{"_uid":326,"image":327,"title":331,"component":332,"copyright":9,"image_style":333,"component_style":334},"c920a8ce-350b-4c3d-8fb0-8a99b28ad5be",{"id":328,"alt":9,"_uid":329,"name":9,"focus":96,"title":9,"filename":330,"copyright":9,"fieldtype":11},1818907,"31abfaa9-8dd7-4701-ab61-d8a9e9d2b164","https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F966x800\u002F5218661dae\u002Fhigh-hip.png","High hip dislocation","Image",[],[324],{"_uid":336,"text":337,"component":316,"text_style":338,"component_style":339},"8efc666e-3e94-4bd0-83a7-db457a6ec862","## When the pain becomes unbearable something must be done\n\nAs an alternative to the extreme disadvantages of hip joint fusion, an artificial hip joint is sometimes the only sensible measure in the case of a painful high hip dislocation, even at a young age. Before the artificial hip joint can be implanted, however, the challenge of bringing the leg into the correct position in relation to the pelvis must be mastered.",[],[],{"_uid":341,"image":342,"title":345,"component":332,"copyright":9,"image_style":346,"component_style":347},"cbe0ca7e-7337-4405-8649-5a7d8fa66e02",{"id":343,"alt":96,"name":9,"focus":96,"title":96,"filename":344,"copyright":96,"fieldtype":11},2214008,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F5446x1833\u002Fdc7c18ff9c\u002Fhip_series_2.png","Hip distalization with a new method developed at ZEM-Germany",[],[],{"_uid":349,"text":350,"component":316,"text_style":351,"component_style":352},"a978f4e7-572c-4faa-9120-806de87dd188","## New perspectives with distraction nails",[],[],{"_uid":354,"text":355,"component":316,"text_style":356,"component_style":357},"58b2eee3-3102-4aa8-9d03-e99de78a7ec7","At ZEM-Germany, a revolutionary idea was born to open up new perspectives for patients with a painful high hip dislocation, which has attracted a great deal of international attention. A patented pelvic support plate in combination with the proven FITBONE intramedullary distraction nail, makes it possible for the first time to slowly pull down the femur (\"distalization\") without an external fixator and thus create the possibility of implanting an artificial hip joint in an anatomically correct position. In the first surgical step, the new pelvic support plate is positioned above the future position of the cup of the artificial hip, and firmly screwed to the pelvic bone. A FITBONE distraction nail is implanted in the femur and connected to the pelvic support plate via a ball and socket joint. During this first surgical step, the final artificial prosthetic cup is already implanted in the correct position, at the same height as the opposite side. If necessary, the acetabular roof can be augmented with bone from the resected femoral head. After 5 days, the patient leaves the clinic and immediately begins the process of pulling the leg down into its proper position. Following a set protocol, the leg is pushed 3 mm\u002Fday in the first week, 2 mm\u002Fday in the second week and then 1 mm\u002Fday afterward, so that the soft tissues and especially the sciatic nerve can adapt to the slow stretching. The decisive advantage: If the nerve does not tolerate this stretching, the patient feels numbness and the distalization can be slowed down. This virtually eliminates the potential for nerve damage. As soon as the femur has reached the anatomically correct position, after a short relaxation phase, the FITBONE distraction nail is removed during the second operation and a regular prosthesis stem is implanted, which can then articulate with the already implanted cup. In addition to the anatomically correct prosthesis position, another advantage results: the pre-existing leg shortening is usually completely compensated for! In Germany, this new procedure is so far only available at ZEM-Germany and has led to impressive results to date.",[],[358],"lg:col-span-8",{"_uid":360,"image":361,"title":364,"component":332,"copyright":9,"image_style":365,"component_style":366},"2adcf6e3-990c-4afb-93f8-3dd13652c059",{"id":362,"alt":96,"name":9,"focus":96,"title":96,"filename":363,"copyright":96,"fieldtype":11},1773188,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F740x1480\u002Fba63ab98d0\u002Fcase9_4.jpg","Graphic",[],[367],"lg:col-span-4",{"_uid":369,"title":76,"stories":370,"component":380},"2430e123-1763-4b06-a2e6-59e7831ee89f",[371],{"uuid":372,"full_slug":373,"content":374},"c9327d4f-83c3-4851-a30a-55dc9689850b","en\u002Fcases\u002Fhip-dislocation",{"_uid":375,"_editable":-1,"image":376,"intro":379,"meta_title":281},"afeb174a-53c1-4757-838f-18a9d18869f2",{"id":377,"alt":96,"name":9,"focus":96,"title":96,"filename":378,"copyright":96,"fieldtype":11},1773189,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F1638x3274\u002Ffc48a7f8e0\u002Fcase9_1.jpg","A 28-year-old female patient with undiagnosed hip dysplasia developed a migration of the femoral head over years with increasing pain and a shortening of the leg. Despite her young age, an artificial hip joint was the only reasonable treatment option, but first the leg had to be brought into the correct position.","Reference",{"id":382,"alt":96,"name":9,"focus":96,"title":96,"filename":383,"copyright":96,"fieldtype":11},2692144,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F9567x3958\u002F17248b0850\u002Ffitbone_hip.png","If the femoral head (ball) is displaced upwards due to a maldevelopment of the acetabulum (socket) and the leg is shortened as a result, a new method developed at ZEM-Germany can be used to reposition the hip joint into the correct position. After this procedure, the implantation of an anatomically correct prosthesis is made possible and the leg is lengthened at the same time.","Page",[],[],"If the femoral head has permanently protruded upwards from the socket and the leg is too short as a result, ZEM-Germany offers a new type of leg lengthening.","hueftdistalisierung","en\u002Fexpertise\u002Fhip-dislocation",130,[393],"Bild fehlt",780693,"60fee4f1-85a4-44b2-b4bf-07418ede178f","2021-05-17T15:59:52.000Z",[],"spezialgebiete\u002Fhueftdistalisierung",[400,402,406,410,414],{"path":401,"name":281,"lang":195,"published":21},"expertise\u002Fhip-dislocation",{"path":403,"name":404,"lang":405,"published":21},"espectro-de-tratamiento\u002Freposicionamiento-de-una-cadera-dislocada","Reposicionamiento de una cadera dislocada","es",{"path":407,"name":408,"lang":409,"published":21},"tyf-alalaj\u002Fiaadh-wdha-alwrk-almkhlwa","إعادة وضع الورك المخلوع","ar",{"path":411,"name":412,"lang":413,"published":21},"spektr-lecheniya\u002Fvpravlenie-vyvikhnutogo-bedra","Вправление вывихнутого бедра","ru",{"path":415,"name":416,"lang":417,"published":21},"zhi4-liao2-fan4-wei2\u002Fkuan1-bu4-qian1-yin3-shu4","髋部牵引术","zh",1793682356782]