Hip reconstruction in children with loss of the femoral head secondary to infection

Abstract EN

Septic arthritis of the hip in infants and children is a potentially crippling disease, especially if the condition is not diagnosed early and framed promptly.

Early diagnosis and treatment of infection is mandatory in infants and children with pyogenic arthritis of the hip.

When infection destroys the femoral head of a child, hip instability results and the treatment of long-term sequel is complicated.

Arthrodesis will stabilize the hip and gain some femoral length, but sacrifices hip motion.

Even if arthrodesis is success/in', a flexion-adduction deformity may .develop as the child grows and this may Require corrective osteotomy.

The Age of patients at time of surgery ranged between two and a half and seven years, with an average of 4 years 8 months.

Clinical and radiological measurements of limb length were performed preoperatively, postoperatively and at follow-up for all patients.

Colonna reported his hip arthroplasty procedure for ununited femoral-neck fractures, in which the greater trochanter is placed' in the acetabulum and the.

abductor muscles of the hip are transferred distally on the femoral shaft to improve their function A modified Colonna procedure has been used for the treatment of pathological dislocation of the hip secondary to pyogenic infection in five children The modification made in the procedure is us combination with proximal femoral varus osteotomy that is fixed by plate and screws All patients had full hip extension.

No patient had adduction, abduction or flexion contracture of the affected hip at final follow-up.

However, compared to the preoperative range of motion, all operated hips have decreased range of motion at a different degree.

The average gain in the limb length was46%of the original discrepancy Gait was initially improved d in all patients .however in all patients the limp has persisted for some degree.