Early Experience in Surgical Hip Dislocations in at the Galilee Medical Centre

Michael Assaf Haim Shtarker Riad Dakwar Halil Nasralla
Pediatric Orthopaedics, Naharia Hospital, Israel

Background: the Ganz surgical hip dislocation approach has gained popularity in the management of severe hip diseases. It can be used in serious conditions or residual stages such as Legg-Calve-Perthes disease (LCPD), in slipped capital femoral epiphysis (SCFE) and in fractures of the head of the femur and acetabulum. We present our early experience with surgical hip dislocations.

Methods: The subjects of this study were nine patients with pediatric hip pathologies. Six of them had moderate to severe slipped capital femoral epiphysis. Two with fracture of the femoral head and one with fracture of the posterior wall of the acetabulum. They all were treated using the Ganz surgical hip dislocation approach.

The average age at the time of surgery was 13 years. There were four male and five female patients. The follow up time was two years.Medical records were reviewed to record diagnoses, principal surgical procedures, operative time, blood loss, postoperative rehabilitation, changes in the range of hip joint motion, and complications.

Results: Femoral head-neck osteochondroplasty, open reduction and subcapital osteotomy for slipped capital femoral epiphysis (SCFE) were performed in all patients. Open reduction and stable fixation of the fracture was done in the trauma cases.Hip flexion range improved from a preoperative mean of 85° to a mean of 115.0° at the latest follow-up visit in the SCFE patients group. Full and painless range of motion was achieved in the other patients. No gait abnormalities were noticed. One case with avascular necrosis of the femoral head was noted, and was treated by external fixation for arthrodiastasis.

Conclusions: the Ganz surgical hip dislocation approach provides a safe and wide exposure of the femoral head and neck, which enables complete and precise evaluation of the femoral head and neck contour and seems a safe way to correct hip diseases especially SCFE.