Use of iliofemoral distraction in reducing high congenital dislocation of the hip before total hip arthroplasty.

The iliofemoral distraction with Wagner's apparatus was conducted in 20 adult patients with untreated unilateral congenital dislocation of the hip (Crowe group IV) before total hip arthroplasty. During the distraction period of 8 to 17 days, this technique had effectively reduced high dislocation of 4.5 cm (range, 3.5-5 cm). No pin-tract infection was encountered. Surgical difficulties in total hip arthroplasty for these patients were reduced. Potential problems, such as irreducibility, overshortening, nerve palsy, and displaced femoral fractures, were avoided. At an average follow-up period of 43 months (range, 25-63 months), all patients have excellent or good results, with an average Harris hip score of 94.3 (range, 84-100). Leg length was restored. The iliofemoral distraction is valuable prior to difficult total hip arthroplasty for high dislocation.