Reduction of High Hip Dislocation With a Distraction Nail and Arthroplasty (Preliminary Results of a Novel Technique)

Rainer Baumgart; Mark Dahl; Stephan Horn; Werner Plötz; Tillman Baumgart; Stewart Morrison

doi:10.1016/j.artd.2023.101257

Reduction of High Hip Dislocation With a Distraction Nail and Arthroplasty (Preliminary Results of a Novel Technique)

Arthroplast Today. 2023 Nov 6:24:101257. doi: 10.1016/j.artd.2023.101257. eCollection 2023 Dec.

Authors

Rainer Baumgart¹, Mark Dahl², Stephan Horn³, Werner Plötz³, Tillman Baumgart¹, Stewart Morrison⁴

Affiliations

¹ Limb Lengthening Center Munich, Munich, Germany.
² Gillette Children's Specialty Healthcare, St. Paul, MN, USA.
³ Orthopaedische Abteilung, Barmherzige Brueder, Munich, Germany.
⁴ The Royal Childrens Hospital, Melbourne, Australia.

Abstract

A novel distraction technique is described for total hip arthroplasty in symptomatic high hip dislocation (Crowe IV) combining an intramedullary motorized lengthening nail with a pelvic support plate to gradually stretch hip soft tissues (distalization) and performing total hip arthroplasty with the cup in the primary acetabulum. Twelve patients (15 hips) were identified in a retrospective study via chart review. Medical records and radiographs were reviewed for details of the initial case parameters, surgical details, magnitude of distalization, duration of treatment, outcomes, and complications. Followed by an average of 67.4 mm of distalization, nearly anatomical cup placement, and equal leg length were achieved in all patients. During distalization, pain level was low with acceptable range of motion. One unplanned surgery and no complications with long-term sequelae occurred.

Keywords: Chronic hip dislocation; Distraction nail; Gradual distalization; High luxation of the hip; Total hip arthroplasty.