Hip dislocation during congenital short femur lengthening: a case report of successful conservative management

TL;DR

A 6-year-old boy with a rare femur condition successfully had hip subluxation managed without surgery during lengthening treatment.

Contribution

Demonstrates successful conservative management of hip subluxation during femoral lengthening for congenital short femur.

Findings

Hip subluxation occurred during Orthofix-assisted femoral lengthening in a child with congenital short femur.

Conservative treatment with closed reduction and cast immobilization led to a stable hip with no complications after 15 months.

Early recognition and intervention prevented long-term complications like avascular necrosis.

Abstract

Congenital short femur (CSF) is a rare condition, often requiring iterative femoral lengthening to address limb length discrepancy (LLD). While effective, this procedure can be complicated by knee and hip instability and dislocation. We present the case of a 6-year-old boy with Kalamchi type I CSF and a predicted LLD of 12 cm who developed hip subluxation during progressive Orthofix-assisted femoral lengthening. Conservative management with closed reduction under sedation and pelvic cast immobilization was successful with a stable hip at 15 months follow-up with no stiffness or evidence of avascular necrosis. This case highlights the risk of hip subluxation during femoral lengthening for congenital short femur and demonstrates the effectiveness of conservative management in achieving successful results. Early recognition and prompt intervention are essential to prevent long-term complications.

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