PELVIC SUPPORT OSTEOTOMY WITH ILIZAROV METHOD;

OUTCOME OF PELVIC SUPPORT OSTEOTOMY WITH ILIZAROV METHOD IN PATIENTS UNDERGOING GIRDLE STONE PROCEDURE.

Abstract

Objectives: To determine the outcome of pelvic support osteotomy with Ilizarov
method in patients undergoing Girdle stone procedure in terms of pain relief and limb length
discrepancy. Study Design: Descriptive case series. Setting: Department of Orthopaedic
and Spine Surgery, Ghurki Trust Teaching Hospital/Lahore Medical & Dental College, Lahore.
Duration of Study: Six months (19-11-09 to 18-05-10) for sample collection and follow up
for next one year after the procedure. Materials and Methods: Forty five patients having hip
joint problems were included. The radiographs would include plain radiographs of the pelvis
in neutral and single limb standing position and the femur of involved side to assess the pelvic
obliquity. Surgery was performed in the supine position under spinal anesthesia. A proximal
femoral osteotomy was performed at the level of ischial tuberosity. The other distal femoral
osteotomy was performed to lengthen and adjust the mechanical axis. Both these osteotomies
were then stabilized with Ilizarov external fixator. The standard rate of distraction is 1 mm/day
for lengthening. Results: There were 30 male patients and 15 were female patients with male
to female ratio was 2:1. The mean ± SD between the ages was 23.69±7.80 years. Among all
patients, 43 patients had pain relief and 41 patients of limb length discrepancy. Conclusion:
By using the Ilizarov technique, we could prevent the valgus effects created by the valgus
extension osteotomy while achieving lengthening of the femur through the distal osteotomy in
the femur. It is an excellent technique for those patients who are not fit for total hip replacement.