Pelvic Salvage Technique for Peri-Implant Fracture with Osteomyelitis Post-Hip Arthrodesis
Score and Comment on this Case
Clinical Details
Clinical and radiological findings: The patient is a case of peri-implant fracture in the context of a history of hip arthrodesis complicated by osteomyelitis. The clinical scenario involves multiple prosthesis failures due to infection. Radiological findings are not explicitly detailed, but the condition suggests significant structural compromise and infection-related changes.
Preoperative Plan
Planning remarks: The preoperative plan involves a pelvic salvage technique aimed at patients with multiple prosthesis failures due to infection, who are ambulatory or young dysplastic patients unsuitable for hip replacement. The technique includes controlled fractures to alter the support area at the ischial tuberosity, enhancing range of motion and promoting independent gait. Bone lengthening is planned to achieve limb symmetry at a rate of 1 mm per day. A 3D planning process is utilized for conversion from external to internal fixation using a custom plate.
Surgical Discussion
Patient positioning: Not specified.
Anatomical surgical approach: An anterior approach is utilized for the conversion from external to internal fixation. This involves the removal of previous fixation materials and preparation for the application of a custom internal fixation plate.
Operative remarks:The surgeon remarks on the necessity of this technique in cases where traditional hip replacement is not feasible due to infection or dysplasia. The approach allows for controlled fracture management and bone lengthening, facilitating improved functional outcomes and gait training post-consolidation.
Postoperative protocol: Postoperative rehabilitation includes gait training following the removal of fixation material after complete consolidation of regenerated bone. Specific details on weight-bearing status or physiotherapy protocols are not provided.
Follow up: Not specified.
Orthopaedic implants used: TL-HEX and TRUELOK external fixation systems, custom internal fixation plate.
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Jhon Perez Casado
- Colombia , Cali - Valle del Cauca
- Area of Specialty - Lower Limb
- Position - Specialist Consultant
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19 Jul 2025
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Full Citation
Cite this article:
Perez Casado, J.J.. (2025). Pelvic Salvage Technique for Peri-Implant Fracture with Osteomyelitis Post-Hip Arthrodesis. Journal of Orthopaedic Surgery and Traumatology. Case Report 27118390 Published Online Jul 19 2025.