Ilizarov Hip Reconstruction for Post Infective Femoral Head Destruction

The Ilizarov hip reconstruction or pelvic support osteotomy is based on the concept of a pelvic support osteotomy as outlined by Hass (Palliative procedures. In: Thomas C (ed) Anonymous congenital dislocations of the hip. Springfield, p 289, 1951), with the concept of a subtrochanteric level for the osteotomy being introduced by Schantz in 1922. In pediatrics it is particularly useful in cases of femoral head destruction and migration of the proximal femur, the most common causes being postinfective or complications following DDH management. The procedure is only occasionally used in adults because of advances in total hip replacement. Good functional outcomes have been reported with follow-ups of 5–7 years (El-Mowafi, Acta Orthop Belg 71:686–691, 2005). One potential disadvantage of a pelvic support osteotomy is the theoretical difficulty of converting it to a hip replacement, but doubtless technical advances and the ingenuity of arthroplasty surgeons will overcome the challenge, and this theoretical difficulty should not be considered a contraindication to what is a very useful, if technically challenging, procedure in the right patient.