Wanger cone with subtrochanteric osteotomy in the treatment of Crowe type IV developmental dysplasia of the hip
TANG Yan-feng
LI Hong-jun
ZHU Ying-jie
CAI Hong-min
JIA Yu-dong
LI Qi-yi
LIU You-wen
Abstract：Objective To investigate the effectiveness of the subtrochanteric osteotomy with the Wanger cone in total hip arthroplasty ( THA ) for Crowe type IV developmental dysplasia of the hip ( DDH ) in adults.Methods From January 2009 to January 2015, 15 patients ( 17 hips ) with Crowe type IV DDH were treated by THA procedures of subtrochanteric osteotomy with Wanger cone, aged 18 - 49 years ( mean 39.4 years ). The left hip was involved in 8 cases, the right hip in 5 cases, and bilateral hips in 2 cases. The both limps were not of the same length. The length of the involved limp was shorter than the normal ( 3.4 - 4.6 cm, mean 3.8 cm ) in 13 cases, including 4 cases with spinal deformity. The results of Trendelenburg sign were positive in 10 cases. X-ray iflms showed high complete dislocation of the involved hips.Results All patients underwent THA procedures of subtrochanteric osteotomy with Wanger cone. The length of subtrochanteric osteotomy was 2.0 - 4.5 cm ( mean, 3.5 cm ). The incisions healed by the ifrst intention. There were no complications such as infection, dislocation, prosthesis loosening, or sciatic neurovascular injury. 2 cases had transient sciatic nerve symptoms in 2 months. The average follow-up was 42.5 months ( range: 13 - 62 months ). Four cases were of delayed union and osseous healing was achieved in 10 months. Lower limb shortening < 1 cm occurred in 8 cases, 1 - 2 cm in 5 cases, and > 2 cm in 2 cases. Harris score was improved from ( 33.1 ± 4.2 ) points preoperatively to ( 92.8 ± 2.7 ) points postoperatively.Conclusions Subtrochanteric osteotomy with the Wanger cone in THA for Crowe type IV DDH in adults is a good option when limp length shortening > 4 cm, which is effective in decreasing the risk of neurovascular injury with satisfactory short-term results.
Keywords：Hip jointBone diseasesdevelopmentalOsteotomyArthroplastyreplacementhipHip prosthesis
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 503-506 )