Reconstruction with tibial lengthening for limb length discrepancy in Crowe Type IV developmental dysplasia of hip in adulthood.

BACKGROUND

Persistence of hip dysplasia into adolescence and adulthood can lead to an abnormal gait, which would do harm to patients' physiological and psychological health. The aim of this study was to summarize our results of tibial lengthening for reconstruction of limb length discrepancy in Crowe Type IV developmental dysplasia of hip in adulthood.

METHODS

Between January 2000 and December 2002, 11 patients' limb length discrepancy in Crowe Type IV developmental dysplasia of hip was treated by tibial lengthening. There were 8 women and 3 men, aged from 18 to 25 years, averaged 21.2 years. The limb length discrepancy was 4.0-7.1 cm.

RESULTS

Eleven patients were followed up for a mean of 110 months. The limping was much improved from a moderate or severe degree to a mild degree in all patients. In the group of callus distraction with external fixation, the average external fixation index was 37.0 days/cm. In the group of callus distraction over an intramedullary nail, the average external fixation index was 16.6 days/cm, and the mean radiographic consolidation index was 34.4 days/cm. The extent of lengthening ranged from 4.0 to 7.0 cm.

CONCLUSIONS

Tibial lengthening may be a reliable treatment for untreated unilateral developmental dysplasia of hip in adolescents without pain but eager for improving limping.