Femoral Neck Reconstruction: Management of Sequelae of Septic Arthritis of Paediatric Hip

Authors: Ajai singh [1], R. N. Srivastava [1]
Authors Affiliations: [1] K. G. Medical University, Lucknow, India
Address of Correspondence:
Dr Ajai Singh, 2/59, Viram Khand, Gomti Nagar, Lucknow
Email: as29762@gmail.com

Aim – To highlight the 2.6 years follow up of reconstruction of Sequelae of Septic Arthritis of six Paediatric Hips Background- The Sequelae of paediatric hip septic arthritis is complex and diverse. The ultimate purpose of the management of these Sequelae is to provide a stable hip with minimum loss of movements.

Material & Methods:    Case Reports – All six cases were male (average age 6.3 years) with definite past history suggestive of infective pathology of hips during infancy. All were treated earlier with incision drainage of abscess around affected hips. All were presented with difficulty in walking with limb shortening. Radiologically, all were Choi Type III B or Forlin Milani type 2A. After initial tibial skeletal traction for mean 2.3 weeks, Y – osteotomy of proximal femur was performed with fixation of remnant of head located in acetabulum with medial arm of this Y by K- wire with POP hip spica for 12 weeks.

Results: Average follow up was 3.6 years. Average preop shortening was 2.7 cm which was reduced to 0.9 cms. Abductor mechanism recovered in all children. No excisional arthroplasty with or without subtrochantric femoral osteotomy was performed in any of the patient. No avascular necrosis occurred in any of the hip. Both abduction (>) adduction movements were present in all children.

Conclusion:  Our procedure was able to provide satisfactory and acceptable hips in all six cases of sequelae of Septic Arthritis of Paediatric Hips. Longer follow up is required in more cases to establish this procedure.