After a difficult birth and experiencing severe problems with his hips and legs for much of his early life, five-year-old Thomas Meadows is now like any other little boy his age – thanks to the ‘life-changing’ Montgomery hip screw.
The orthopaedic device – designed by Richard Montgomery, consultant trauma and orthopaedic surgeon at James Cook, has transformed Thomas’s life and is credited with helping the youngster walk properly and unaided.
Mum Joanne Feather, of Redcar, said: “It’s fantastic – we never thought he would be able to walk and certainly not without a limp at least.”
Thomas was delivered by caesarean and born severely breech. The very next day during a health visit the nurse carrying out a hip check discovered his legs were very floppy and advised Thomas’s parents to use two nappies at a time on the baby to try and help. Later Joanne and her partner Justin Meadows were advised to use a plastic splint in Thomas’s nappy to push the infant’s legs apart in another bid to aid joint alignment.
But after x-rays and scans showed Thomas was still suffering severe problems, he underwent an operation which revealed his hip sockets had failed to develop properly and the ball joints on top of both of his femurs were pointing outwards.
Doctors had to wait until he was a year old before they could operate and Thomas then underwent a realignment osteotomy where his femurs were cut, shortened and re-shaped.
The ball joints were re-positioned the correct way to realign the hips and fixed temporarily in place by the Montgomery hip screw. A cast was also put on that reached from Thomas’s hips to his ankles, which the youngster wore for several months.
The hip screw was removed a year later – and the change in Thomas’s mobility was nothing short of dramatic, according to his proud mum.
“It has made a massive amount of difference,” Joanne said. “He’s unbelievable now! The only thing he finds difficult is riding a bike, but otherwise he is like any other normal little boy his age.
“He wouldn’t have walked without Mr Montgomery. It’s changed his life.
“It’s horrible to think that, had Thomas grown up in a country which lacked medical developments and orthopaedic devices like this, he would have effectively been disabled.”
The Montgomery hip screw
The Montgomery hip screw is a small stainless steel hip plate which comes in two sizes, one for infants and toddlers, and one for larger children. It helps preserve and reconstruct the hip joint in children who suffer congenital dislocation or developmental dysplasia of the hip, Perthes’ disease, or cerebral palsy hip dysplasia.
Left untreated, these conditions lead to pain, early degenerative joint disease or impaired walking ability, but they can be effectively treated by treatments such as a realignment osteotomy.
A review has revealed the Montgomery hip screw could cut complication rates by over 75% compared to earlier devices in common use, saving children and their parents the trauma and worry of unplanned follow-up surgery.
“The implant in common use 20 years ago – and still in use in some hospitals – was poorly designed and had a significant risk of causing the bone to split during surgery,” said Mr Montgomery.
“I experienced this myself in one operation I did while using the old style implant. The child was in traction for a couple of weeks after operation but I felt absolutely awful about it and it got me thinking about how we could avoid this.
“The next design used a single screw to fix the osteotomy and the complication rate almost halved to about five per cent with elimination of the fracture risk, but the bone would sometimes spin around the screw causing rotational instability.
“The Montgomery hip screw uses two screws to overcome this rotational instability and has brought the overall complication rate down even further to less than 2%. It is also shorter, which translates to smaller surgical scars.”