Yuen Jin Chuan, Pang Hee Nee, Kow Ren Yi
Orthopaedics, Hospital Tengku Ampuan Afzan, Kuantan, MYS.
Orthopedics, Singapore General Hospital, Singapore, SGP.
Cureus. 2023 Jun 3;15(6):e39925. doi: 10.7759/cureus.39925. eCollection 2023 Jun.
Although uncommon, neglected developmental dysplasia of the hip (DDH) poses a technically demanding problem for treating surgeons. Due to the congenital malformation of the native hip joint and distortion of the surrounding soft tissue, addressing limb-length discrepancy is intricate. Despite detailed planning and meticulous soft tissue handling, complications can be difficult to avoid in these patients even under experienced hands. In this case report, we present a 73-year-old lady with neglected DDH who had undergone initial total hip arthroplasty and subsequent revision surgery that failed due to aseptic loosening. Due to limited length in the distal femur, we used a telescoping allograft prosthetic composite (APC) to provide adequate length to the native distal femur during revision with proximal femur fixation. This technique can help avoid the need for total femur replacement (TFR) surgery, which is more invasive and may require tibia replacement.
尽管少见，但被忽视的发育性髋关节发育不良（DDH）给治疗外科医生带来了技术上要求很高的难题。由于天然髋关节的先天性畸形以及周围软组织的扭曲，解决肢体长度差异很复杂。尽管进行了详细规划和细致的软组织处理，但即使在经验丰富的医生手中，这些患者仍难以避免并发症。在本病例报告中，我们介绍了一位73岁患有被忽视的DDH的女性，她曾接受初次全髋关节置换术，随后因无菌性松动而导致翻修手术失败。由于股骨远端长度有限，我们在股骨近端固定翻修术中使用了可伸缩同种异体移植假体复合物（APC），为天然股骨远端提供足够长度。该技术有助于避免进行更具侵入性且可能需要更换胫骨的全股骨置换（TFR）手术。
