THE RESECTION-ANGULATION OPERATION FOR HIP-JOINT DISABILITIES

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Abstract
As its designation indicates, the resection-angulation operation consists of two separate procedures, the validity of both of which has been long established. Resection of the femoral head and neck has been employed in the treatment of tuberculosis and of osteoarthritis of the hip by Girdelstone3 and others. While this restores mobility of the hip, it converts the femur into a “broomstick” that affords no stability. For the correction of this disability, both Lorenz6 and Schanz14 devised operations that have proven to be successful. Experience has demonstrated that the Schanz type of osteotomy is to be preferred, since, for any given degree of abduction of the distal osteotomized portion of the femur, it affords greater stability with less limitation of motion and less shortening of the extremity than does the Lorenz type of osteotomy.9 Whereas earlier proponents of the subtrochanteric osteotomy believed that high degrees of abduction afforded better results, it was shown subsequently that abduction of the distal portion of the osteotomized femur led to the creation of another angle, “the postosteotomy angle,”10 the size of which was determined critically by the inclination of the outer wall of the pelvis.13 Postosteotomy angle values less than that of the pelvic wall inclination do not afford sufficient stability, while values in excess of the critical value result in limitation of motion and apparent shortening of the opposite, unaffected extremity.8,9

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