AMPUTATION FOR DISCREPANCY OF LIMB LENGTH IN TUBERCULOSIS OF THE HIP

¹ Department of Orthopaedic Surgery, University of Illinois School of Medicine

In the case described, a typical patient with tuberculosis of the hip, who was treated for a long time in traction and many plaster casts, with manipulation of the extremity under anaesthesia to correct apparent deformity about the knee, had two operations upon the hip with further immobilization. When fusion of the joint finally occurred, the extremity was 13.75 centimeters shorter than its normal mate, and a calcaneocavus deformity of the foot was present.

The method of treating such a useless and unsightly extremity includes the following steps:

1. Fusion of the knee joint;

2. Amputation of the extremity, so that the end of the stump will be at the same level as the knee joint of the "good" leg;

3. Fitting the patient with the proper prosthesis, after rehabilitation and training by prior application of a walking pylon.

The excellent result in the case described warrants serious consideration of this method of treatment for an extensively deformed and shortened lower extremity, resulting from damage to the susceptible epiphyses during so-called "conservative" treatment of hipjoint tuberculosis or other disease requiring prolonged immobilization of the lower extremity.

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