Hip Deformities Treatment


Treatment of hip deformities using SLDF system

Ghassan Salameh ; MD. Ph.D., Mazeh, Sheh Saad , Damascus; Syria

ghassanorth@yahoo.com
Treatment of hip and deformities like old hip dislocations or suluxations or even paralytic malformations and consider a special hinges for correction, hip and knee axis need a special correlation of alignment For this reason a special hinges are modified for treatment of either of isolated hip, knee deformities or when we have combined deformity an combined hinges modified for treatment both of hip and knee deformities, the used hinges are modified system of Salamehfix{ SLDF}
Cases which treated are neglected hip dislocations or subluxations or post traumatic and post paralytic hip mal alignment and the main principal procedure done it’s the pelvic support osteotomy according to Ilizarov principal in treatment of Neglected dislocations in order to restore femur length and hip and knee alignment , the same principal was used in treatment some of hip post paralytic problems , because of muscle and bone insufficiency we have to make bony support to the pelvis in order to replace some of muscle paralyses this will decrees of Trandelenburg gait and limping and at the same time we can restore limb length inequality and correction of knee deformity .Other cases where treated are some of hip and knee post traumatic or congenital or even some cases of Osteoarthritis.
The used system is differs from others by simplicity, small size in correlation to its functional hinges and stability of fixation and gives good results.

X-Ray of Congenital hip dislocation in a girl 26 years old; high dislocated left hip and oblique pelvis

We can see the girl before treatment ,shortness of left lower extremity and oblique pelvis ;this cause limping and pain in the spine ,and she had pain in the hip joint because of beginning osteoarthroses,


In cases of hip paralytic insufficiency pelvic Support osteotomy is very helpful, like in cases of poliomyelitis and other paralytic cases in which patients suffers of limping and hip muscle insufficiency ; This is a case of young girl 25 yrs old she had poliomyelitis Slight hip and knee flexion deformity with muscle paralyses and Shortness five cm of right lower extremity, she couldn’t walk without a brace

We can see her before treatment and after treatment was carried for Here correction of hip deformity, so the proximal femur will support The pelvic and takes a part of paralytic muscle function, We can see the patient standing position after treatment the pelvis Are in balanced position horizontal and the hip and knee in Strait position and the lower limbs in the same long, Even the face of the patient is changed due to the correction.

Hip and Knee Deformities Correction using Mini external fixation / Salamehfix 4 /

§Hip and Knee  deformity often combined with:

     pelvic obliquity  and static scolioses which is related to many factors :
§
§hip deformities
§  knee         deformities 
§limb length discrepancies
§ paralytic deformity

 

§Combined deformity§In order to achieve pelvic balance we have  to consider many factors :
     Muscle power on each hip
     Mechanical axes of the hip
§And we have to consider a special method  for correction, hip and knee axis.
§Salamehfix 4 is a simple small external arc system , allows stable fixation and deformity correction in various directions .
 

 

42 yrs. old man with severe Poliomyelitis ,sever hip and knee flexion deformity, hand to knee walking

 

Correction of hip and knee flexion deformity by osteotomy and using special modified arc system Salamehfix 4

 

 

 


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