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DOUBLE FEMORAL OSTEOTOMY FOR THE TREATMENT OF SEVERE SEQUELAE OF THE IMMATURE HIP

DUPLA OSTEOTOMIA DO FÊMUR PARA O TRATAMENTO DE GRAVES SEQUELAS NO QUADRIL IMATURO

ABSTRACT

Objective:

To evaluate the results of double femoral osteotomy for the treatment of severe sequelae of the hip.

Methods:

Immature patients with anatomical loss of the hip were treated with pelvic support osteotomy in the distal femur to correct lower limb shortening, they were evaluated clinically and radiographically.

Results:

Eleven cases (eleven hips) were assessed with verage follow-up of three years. The mean age of the patients was 14.7 years. Seven patients had sequela of infectious arthritis; three had sequela of developmental dysplasia of the hip and one patient had a sequela of slipped capital femoral epiphysis. Preoperatively, the gluteus medius was insufficient in all patients, and it became negative in ten of them. The average of lower limb shortening was 5 cm (2.5 to 7 cm) and reduced shortening was 1.9 cm (0 to 4 cm). According to Paley Classification, 72.7% of complications were considered problems, 90.9% were considered obstacles and 27.2% complications, among which the limitation of the knee flexion was the most frequent.

Conclusion:

The technique yielded good results, considering the severity of the sequela and the absence of a better therapeutic option. No important sequela was associated with the treatment. Level of Evidence IV, Case series.

Keywords:
Hip Joint; Hip Dislocation; Osteotomy; Arthritis, Infectious

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