Type-B-IIIa Hip Rotationplasty: An Alternative Operation for the Treatment of Malignant Tumors of the Femur in Early Childhood* by Winfried W. Winkelmann

Type-B-IIIa Hip Rotationplasty: An Alternative Operation for the Treatment of Malignant Tumors of the Femur in

Early Childhood*

by Winfried W. Winkelmann

J Bone Joint Surg AmVolume 82(6):814-814

June 1, 2000

©2000 by The Journal of Bone and Joint Surgery, Inc.

Figs. 1-A through 1-G: Drawings illustrating the steps of the type-B-IIIa hip rotationplasty (see text for details).Fig. 1-A: The incisions are made with the patient positioned on the unaffected

side.

Winfried W. Winkelmann J Bone Joint Surg Am 2000;82:814


The proximal part of the operation is similar to a hip disarticulation.



The distal part of the operation is similar to a knee disarticulation.



After the leg is rotated 180 degrees, the lateral aspect of the proximal part of the tibia is placed into the acetabulum and fixed in position.



The medial and lateral heads of the gastrocnemius and the tendons of the rotators are attached to the hip capsule, and the tendon of the iliopsoas muscle is attached to the tibial periosteum.



The femoral artery and vein are anastomosed to the popliteal artery and vein, the adductor muscles are reattached to the tibial periosteum and fasciae, the tendons of the gluteus medius

and minimus are fixed to the tibial periosteum and attached to the caps...



The overlapping skin edges are excised with the greater part of the skin taken from the distal flap.



Figs. 2-A and 2-B: Case 6.



The patient is shown jumping over a hurdle.



Figs. 3-A through 3-D: Case 2.



Fig. 3-B: Three years and four months postoperatively, there are signs of remodeling, with formation of a partial femoral head and acetabulum.



Fig. 3-C: Six years and ten months postoperatively, there is increasing centering of the femoral head, which is starting to have a more normal appearance.



Fig. 3-D: The contralateral hip is shown for comparison.



Figs. 4-A and 4-B: Case 6.



Three sections from the coronal T1-weighted fast spin-echo sequence showing the thick cartilage covering the newly formed femoral head that conforms with the acetabulum.



Documents

Type-B-IIIa Hip Rotationplasty: An Alternative Operation for the Treatment of Malignant Tumors of the Femur in Early Childhood* by Winfried W. Winkelmann