FEMORAL LENGTHENING AFTER TYPE IVB SEPTIC ARTHRITIS OF THE HIP IN CHILDREN

Septic arthritis of the hip in the newborn baby can result in severe l ong-term sequelae in the form of dislocation of the hip, loss of movem ent, and growth disturbance with leg-length discrepancy. For more seve re discrepancies often with concomitant hip dislocation, no good solut ions are readily available. This series comprised four patients with C hoi's type IVB septic hip sequelae. They all had associated multiple-j oint sepsis and resultant major leg-length discrepancies ranging from 6.9 to 14 cm. All underwent distraction lengthening with simultaneous correction of angulation and other deformities of the femur, three wit h the Ilizarov and one with the Orthofix system. The age at operation ranged from 9 to 13 years, with an average follow-up of 3 years. The o verall lengthening achieved ranged from 4.5, 6.8, 12, to 13 cm, with t he lengthening index from 24 to 51 days/cm. All hips remained stable, and the loss of range of hip and knee motion was not significant. Othe r complications included one deep pin-tract infection and one fracture of the callus.