抄録
High-riding DDH cases are often treated by THA with subtrochanteric osteotomy to avoid sciatic palsy by acute over-traction, but it has a disadvantage that leg length equality cannot be obtained. To prevent leg length inequality without sciatic palsy, we have done 2-stage surgery with leg elongation. In the first stage the proximal attachment of tensor fascia lata and the fascia of gluteus medius were detached. The adductors and iliopsoas were also released. Then the femoral neck was cut and the pins of a leg elongation device were inserted safely by means of a 3D preoperative planning system. Five centimeters of leg elongation was done safely in 2 weeks with no stiff feeling or sign of sciatic palsy.
Total hip arthroplasty was done 3 weeks later, at the anatomic hip center, with 5cm elongation, without any complications.