Patel Akshar H, Kreuzer Stefan W, Sherman William F
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
Inov8 Orthopedics, Houston, TX, USA.
Arthroplast Today. 2021 Feb 23;8:262-267.e1. doi: 10.1016/j.artd.2021.01.005. eCollection 2021 Apr.
Phocomelia is a rare congenital birth defect marked by hypoplastic or markedly absent limbs. Developmental dysplasia of the hip (DDH) is a congenital disorder with a failure of the native acetabulum to provide complete coverage over the femoral head. The secondary osteoarthritis that develops from DDH is technically challenging for orthopedic surgeons because of distorted anatomy. The present case describes the diagnosis of Crowe 3 DDH in a phocomelia patient with hyperflexion requirements who successfully underwent staged bilateral total hip arthroplasty via a direct anterior approach. It highlights the utility of preoperative computerized tomography and intraoperative computer navigation to assist in implant placement. Recognizing difficult arthroplasty cases in advance is imperative as these cases may require great expertise and more extensive surgical planning.
海豹肢畸形是一种罕见的先天性出生缺陷，其特征是肢体发育不全或明显缺失。发育性髋关节发育不良（DDH）是一种先天性疾病，表现为天然髋臼无法完全覆盖股骨头。DDH引发的继发性骨关节炎由于解剖结构扭曲，给骨科医生带来了技术挑战。本病例描述了一名患有海豹肢畸形且有极度屈曲需求的患者，诊断为Crowe 3型DDH，该患者通过直接前路成功分期进行了双侧全髋关节置换术。它强调了术前计算机断层扫描和术中计算机导航在辅助植入物放置方面的作用。提前识别困难的关节置换病例至关重要，因为这些病例可能需要高超的专业知识和更广泛的手术规划。
