SCHANZ OSTEOTOMY IN D.D.H.: 14–37 YEAR FOLLOW-UP.

M. Heeg; CL De Ridder; JR Van Horn

doi:10.1302/0301-620X.85BSUPP_III.0850271

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SCHANZ OSTEOTOMY IN D.D.H.: 14–37 YEAR FOLLOW-UP.

M. Heeg
CL De Ridder
JR Van Horn

SCHANZ OSTEOTOMY IN D.D.H.: 14–37 YEAR FOLLOW-UP.

Heeg M, De Ridder C, Van Horn J. SCHANZ OSTEOTOMY IN D.D.H.: 14–37 YEAR FOLLOW-UP.. Orthop Procs. 2003;85-B(SUPP_III):271-271. doi:10.1302/0301-620X.85BSUPP_III.0850271

Heeg, M., et al. “SCHANZ OSTEOTOMY IN D.D.H.: 14–37 YEAR FOLLOW-UP..” Orthopaedic Proceedings, vol. 85-B, no. SUPP_III, 2003, pp. 271-271., https://doi.org/10.1302/0301-620X.85BSUPP_III.0850271

Heeg, M., De Ridder, C., & Van Horn, J. (2003). SCHANZ OSTEOTOMY IN D.D.H.: 14–37 YEAR FOLLOW-UP.. Orthopaedic Proceedings, 85-B(SUPP_III), 271-271. https://doi.org/10.1302/0301-620X.85BSUPP_III.0850271

Heeg, M., De Ridder, C. and Van Horn, J. (2003) “SCHANZ OSTEOTOMY IN D.D.H.: 14–37 YEAR FOLLOW-UP..” Orthopaedic Proceedings, 85-B(SUPP_III), pp. 271-271. Available at: https://doi.org/10.1302/0301-620X.85BSUPP_III.0850271

Heeg, M., CL De Ridder, and JR Van Horn. “SCHANZ OSTEOTOMY IN D.D.H.: 14–37 YEAR FOLLOW-UP..” Orthopaedic Proceedings 85-B, no. SUPP_III (2003): 271-271. https://doi.org/10.1302/0301-620X.85BSUPP_III.0850271

Heeg M, De Ridder C, Van Horn J. SCHANZ OSTEOTOMY IN D.D.H.: 14–37 YEAR FOLLOW-UP.. Orthop Procs. 2003 Mar 1;85-B(SUPP_III):271-271. https://doi.org/10.1302/0301-620X.85BSUPP_III.0850271

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Abstract

Purpose: To assess the long-term outcome of Schanz subtrochanteric abduction osteotomy (SO) in patients with long-standing dislocation of the hip

Patients and methods: Between 1962–1981, 11 patients were treated with a SO. Nine patients, in whom 16 SO procedures were performed, were available for follow-up. Seven hips had had failed surgery in infancy, 9 hips had not been operated on previously. The average age at the time of SO was 17.8 (12–29) years. The degree of dislocation at the time of SO was classified according to Eftekhar type B: subluxation; (4 hips); type C: dislocation with neo-acetabulum, (8 hips) patients, and type D: high dislocation, no neo-acetabulum (4 hips). The indications to perform SO were fatigue and a painful lurch in 14 hips and a flexion/adduction contracture with pain in 2 hips. Post-operatively, patients were immobilised in suspended traction for 6–8 weeks, followed by progressive weight-bearing. Follow-up averaged 21 (14–37) years. Follow-up included the Harris-Hip score and ADL-score (Barthel-index); working status, sexual problems, ROM, hip/knee instability and radiographic examination.

Results: Ten secondary surgical procedures were performed at an interval of 6–19 years following SO: shelf procedure ( 5); Epiphyseodesis (3) and total hip (2). The shelf procedures were performed for residual hip pain, at an average of 12 years. The total hips were performed after 17 and 19 years following SO. Both have failed and had complicated hip-revisions. ROM was severely restricted in 4 patients. The mean Harris hips score was 76 ( 27–97). One of six bilateral cases and 2 of 4 unilateral cases had poor functional results. All patients had unlimited ADL activities; 7 patients regularly participated in cycling and swimming. Three female patients experienced minor sexual problems, due to limited abduction. Four patients had 400 excessive valgus at the knee, without clinical or radiographic symptoms. Leg-length discrepancy varied from 0–3 cm.

Conclusion: 1. The results of SO in patients with Eftekhar C/D were surprisingly fair, and poor in type B, subluxation.

Local Host: British Society for Children’s Orthopaedic Surgery. Conference Theme: Congenital Deficiencies of the Lower Limb. These abstracts were prepared by A.Catterall.