Modified Ilizarov hip reconstruction in treatment of adolescent hip instability_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Hongfei ¹ ,  LIANG Xibin ¹ , ZHAO Wei ¹ , GUO Baofeng ¹ , REN Longxi ¹ , QIN Sihe ² , CHEN Jianwen ² , PENG Aimin ³ , YANG Huaqing ³

1. Department of Orthopaedics, ChuiYangLiu Hospital Affiliated to Tsinghua University, Beijing, 100022, P.R.China;
2. Department of Orthopaedics, Rehabilitation Hospital of the National Research Center for Rehabilitation Technical Aids, Beijing, 100176, P.R.China;
3. Department of Orthopaedics, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, 100144, P.R.China;

Corresponding?author：

LIANG Xibin, Email: liangxibin1983@sina.com

Keywords：

Ilizarov hip reconstruction; adolescent; hip instability

DOI：

10.7507/1002-1892.201904107

Video：

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Objective To evaluate the effectiveness of modified Ilizarov hip reconstruction in the treatment of hip instability.Methods The clinical data of 13 young patients with hip diseases treated with modified Ilizarov hip reconstruction between January 2010 and March 2018 were retrospectively analyzed. There were 2 males and 11 females, aged from 14 to 34 years, with an average age of 24.2 years. There were 1 case of hip dysplasia and dislocation due to spinal bifida, 3 cases of hip dysplasia after pyogenic arthritis of the hip, 2 cases of developmental dysplasiaof the hip (DDH) accompanying femoral head necrosis who rejected hip replacement, 6 cases of young DDH refused to undergo hip replacement, and 1 case of bilateral hip dysplasia with dislocation due to sputum cerebral palsy. The disease duration was 2-20 years, with an average of 8.5 years. Preoperative Trendelenburg sign was positive in 12 cases and negative in 1 case. The preoperative Harris score of hip joint was 53.5±8.9 and the unequal length of lower limbs was (46.08±15.73) mm. Postoperative Harris hip score and patients' satisfaction with effectiveness evaluated according to their self scoring were used to assess the effectiveness.Results All 13 patients were followed up 1-5 years, with an average of 2.6 years. Five patients developed postoperative needle infection, which improved after dressing change; 7 patients had limited knee joint activity and improved after knee joint function training. The Trendelenburg sign was negative at 1 year after operation, and the patient’s hip pain symptoms were relieved or disappeared. The Harris hip score of patients at 1 year after operation was 84.5±6.1, which was significantly improved when compared with preoperative one (t=－10.538, P=0.000). According to Harris hip score, the effectiveness results were excellent in 4 cases, good in 5 cases, and fair in 4 cases, with an excellent and good rate of 69.2%. The unequal length of lower limbs was (15.38±7.27) mm, which was significantly better than that before operation (t=11.826, P=0.000). At last follow-up, the patients' satisfaction score was 80%-95%, with an average of 88%.Conclusion Modified Ilizarov hip reconstruction can be used to treat young patients with hip disease who are unsuitable or refuse to undergo artificial hip replacement. Its effectiveness is reliable, and it has unique advantages in limb limp improvement and limb shortening correction.

Citation： WU Hongfei, LIANG Xibin, ZHAO Wei, GUO Baofeng, REN Longxi, QIN Sihe, CHEN Jianwen, PENG Aimin, YANG Huaqing. Modified Ilizarov hip reconstruction in treatment of adolescent hip instability. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(11): 1379-1383. doi: 10.7507/1002-1892.201904107 Copy

1.	夏和桃, 彭愛民, 韓義連. Ilizarov髖關節重建術的臨床研究及改良. 中國矯形外科雜志, 2011, 19(23): 2014-2016.
2.	夏和桃. 實用骨外固定學. 北京: 人民衛生出版社, 2013: 100-120.
3.	Paley D, Herzenberg JE. 矯形外科原則. 陳堅, 譯. 北京: 中國醫藥科技出版社, 2006: 689-694.
4.	Kotlarsky P, Haber R, Bialik V, et al. Developmental dysplasia of the hip: what has changed in the last 20 years? World J Orthop, 2015, 6(11): 886-901.
5.	嚴亮, 夏軍, 黃鋼勇, 等. 成人髖關節發育不良患者股骨近端的解剖形態學特征. 中華骨科雜志, 2013, 33(9): 941-947.
6.	Gursu S, Demir B, Yildirim T, et al. The influence of aetiology of hip instability on the results of pelvic support osteotomy. Hip Int, 2010, 20(4): 518-523.
7.	沈彬, 裴福興, 楊靜. 髖關節發育不良的髖臼重建. 中華外科雜志, 2004, 42(16): 1001-1005.
8.	El-Rosasy MA, Ayoub MA. Midterm results of Ilizarov hip reconstruction for late sequelae of childhood septic arthritis. Strategies Trauma Limb Reconstr, 2014, 9(3): 149-155.
9.	Rozbruch SR, Paley D, Bhave A, et al. Ilizarov hip reconstruction for the late sequelae of infantile hip infection. J Bone Joint Surg (Am), 2005, 87(5): 1007-1018.
10.	李剛. Ilizarov 技術骨科應用進展. 北京: 人民軍醫出版社, 2014: 99-103.
11.	El-Mowafi H. Outcome of pelvic support osteotomy with the Ilizarov method in the treatment of the unstable hip joint. Acta Orthop Belg, 2005, 71(6): 686-691.
12.	Solomin L. The basic principles of external skeletal fixation using the Ilizarov and other devices. 2nd eds. New York: Springer, 2012: 377-379.
13.	Umer M, Quadri TA, Rashid RH. Ilizarov hip reconstruction osteotomy-A review. Int J Surg, 2018, 54(Pt B): 351-355.
14.	楊華清, 彭愛民, 夏和桃, 等. 采用改良伊氏外固定器實施髖關節重建術治療青年高位脫位型DDH 31例報告. 中國矯形外科雜志, 2013, 21(16): 1613-1616.
15.	Jabbar Y, Khaleel A. Experimental model for controlling shear using the Ilizarov frame. Clin Biomech (Bristol, Avon), 2015, 30(9): 995-1001.
16.	楊華清, 章耀華, 韓慶海, 等. 微創截骨 Ilizarov 技術結合髓內釘行股骨延長的療效觀察. 中國修復重建外科雜志, 2018, 32(12): 1524-1529.
17.	Yoshino A, Takao M, Innami K, et al. Equinus deformity during tibial lengthening with ankle orthoses for equalization of leg-length discrepancies. J Orthop Sci, 2011, 16(6): 756-759.

1. 夏和桃, 彭愛民, 韓義連. Ilizarov髖關節重建術的臨床研究及改良. 中國矯形外科雜志, 2011, 19(23): 2014-2016.
2. 夏和桃. 實用骨外固定學. 北京: 人民衛生出版社, 2013: 100-120.
3. Paley D, Herzenberg JE. 矯形外科原則. 陳堅, 譯. 北京: 中國醫藥科技出版社, 2006: 689-694.
4. Kotlarsky P, Haber R, Bialik V, et al. Developmental dysplasia of the hip: what has changed in the last 20 years? World J Orthop, 2015, 6(11): 886-901.
5. 嚴亮, 夏軍, 黃鋼勇, 等. 成人髖關節發育不良患者股骨近端的解剖形態學特征. 中華骨科雜志, 2013, 33(9): 941-947.
6. Gursu S, Demir B, Yildirim T, et al. The influence of aetiology of hip instability on the results of pelvic support osteotomy. Hip Int, 2010, 20(4): 518-523.
7. 沈彬, 裴福興, 楊靜. 髖關節發育不良的髖臼重建. 中華外科雜志, 2004, 42(16): 1001-1005.
8. El-Rosasy MA, Ayoub MA. Midterm results of Ilizarov hip reconstruction for late sequelae of childhood septic arthritis. Strategies Trauma Limb Reconstr, 2014, 9(3): 149-155.
9. Rozbruch SR, Paley D, Bhave A, et al. Ilizarov hip reconstruction for the late sequelae of infantile hip infection. J Bone Joint Surg (Am), 2005, 87(5): 1007-1018.
10. 李剛. Ilizarov 技術骨科應用進展. 北京: 人民軍醫出版社, 2014: 99-103.
11. El-Mowafi H. Outcome of pelvic support osteotomy with the Ilizarov method in the treatment of the unstable hip joint. Acta Orthop Belg, 2005, 71(6): 686-691.
12. Solomin L. The basic principles of external skeletal fixation using the Ilizarov and other devices. 2nd eds. New York: Springer, 2012: 377-379.
13. Umer M, Quadri TA, Rashid RH. Ilizarov hip reconstruction osteotomy-A review. Int J Surg, 2018, 54(Pt B): 351-355.
14. 楊華清, 彭愛民, 夏和桃, 等. 采用改良伊氏外固定器實施髖關節重建術治療青年高位脫位型DDH 31例報告. 中國矯形外科雜志, 2013, 21(16): 1613-1616.
15. Jabbar Y, Khaleel A. Experimental model for controlling shear using the Ilizarov frame. Clin Biomech (Bristol, Avon), 2015, 30(9): 995-1001.
16. 楊華清, 章耀華, 韓慶海, 等. 微創截骨 Ilizarov 技術結合髓內釘行股骨延長的療效觀察. 中國修復重建外科雜志, 2018, 32(12): 1524-1529.
17. Yoshino A, Takao M, Innami K, et al. Equinus deformity during tibial lengthening with ankle orthoses for equalization of leg-length discrepancies. J Orthop Sci, 2011, 16(6): 756-759.

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