Hip Fusion with an External Fixator

Although the long-term outcomes of total hip arthroplasty continue to improve, their survival in adolescent patients still remains a serious concern. In adolescent patients with severe degenerative joint disease of the hip, it can be argued that hip fusion is still the preferred treatment option. Short-term problems with hip fusion include nonunion, malalignment, and limb length discrepancy. Long-term problems include degenerative low back pain and ipsilateral knee pain as well as a difficult conversion to total hip arthroplasty. While the short-term problems can be minimized using the approach described below, the long-term problems of adjacent segment degenerative joint disease cannot and may in fact necessitate future conversion to total hip arthroplasty. Avoiding the use of complex plating techniques and minimizing trauma to the abductor musculature during hip arthrodesis are important factors to consider for future total hip arthroplasty.