A tibial-bone-peg shelf was constructed in fourteen cases of congenitally dislocated or inadequate hips and in five cases of pathological dislocations resulting from pyogenic coxitis.
The material is too limited and the time since operation in most cases too short to judge well the end results. This shelf has certain advantages and disadvantages over the shelf turned down from the ilium.
It creates a more firmly anchored and a heavier shelf than that made from the ilium. Wright extension or pin or wire fixation of the femur to the cast is not necessary. The periods of immobilization and confinement to bed have been materially shortened and upward displacement of the shelf has not come about.
The range of motion has not been all that could be desired, but, on the average, it has been about as great as that obtained after the iliac-shelf operation.
It is a more formidable operation than that of creating an iliac shelf and necessitates two incisions. However, if one operating team removes the grafts while another exposes the hip, reduces the dislocation, and prepares the field, the time is reduced to approximately that required for constructing an iliac shelf, and the procedure does not produce any appreciable amount of shock.
(C) 1935 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.