Congenital hip luxation

A 7-month old girl showed a congenital high hip joint luxation which had initially been treated with an extension and immobilization with a Fettweis cast. When the coverage of the acetabulum of the right hip joint continued to be unsatisfactory (CE-angle 14° right, Tönnis grade 3, highly pathologic), a pelvic osteotomy according to Salter with 2 Cerasorb^® wedges (12x 35x15mm) was performed in the meanwhile 6-year old girl. Post surgery, a hip spica cast was applied and left to remain for 6 weeks. As early as 12 weeks later, x-ray monitoring showed very good osteointegration of the β-tricalcium phosphate wedges with proper positioning in the osteotomy gap. After 16 weeks the Kirschner wires were removed. During the final examination 15 months post surgery, mature bone structure was recognizable with no bone substitute material visible. Furthermore, a proper coverage of the acetabulum of now 34° (normal median value is 25% according to Tönnis) was found. To date, the patient does not experience discomfort and is clinically symptom-free.

A: Pre-operative

B: 1 Month. Sharp contours and homogenous density of Cerasorb^® block is visible.

C: 3 Months. Beginning resorbtion is evident.

D: 15 Months. Complete resorbtion and bony regeneration.

Images courtesy Dr. P. Behrens, Univ. Hosp. Schleswig-Holstein Luebeck