抄録
We report a case of subtrochanteric femoral shortening oblique osteotomy in high dislocation of the hip with total hip arthroplasty. A 71-year-old woman, suffering from a dislocated hip (Crowe type IV), was treated with a modular femoral component (S-ROM-A). The operation was carried out through a posterior approach. The acetabular component was placed at the level of the true acetabulum. The lengthening of the treated limb was 40mm. At follow-up, she reported significant pain relief and functional improvement. The osteotomy appeared to be healed on radiograph by 3 months. This technique minimizes potential complications, allows for correction of severe femoral neck anteversion, and gives excellent rotationary stability, while preserving the proximal femur for better press-fit cementless fixation. THA for Crowe type IV developmental hip dysplasia is a safe and effective procedure, that can improve not only hip function, but also lumbosacral and knee pain owing to a dramatic correction of static body balance. However this procedure poses a wide spectrum of difficulties and can present a serious risk of complications. A successful result depends on a complete preoperative assessment of the patient, attention to the details of the surgical procedure performed with an adequate prosthesis, and a reasonable selection of indications.
