Distalization with Motorized Intramedullary Nail for High Dislocation of the Hip Before Arthroplasty

CASE: We present 3 patients (a 19-year-old man, a 37-year-old woman, and a 66-year-old woman) with chronic high hip dislocation and severe limb length discrepancy, managed with gradual soft tissue distraction using a motorized intramedullary nail and a temporary cup before total hip arthroplasty. All patients had at least 1 year of follow-up. Complications included transient foot drop (resolved), and 1 case of early infection and persistent foot drop. CONCLUSION: This approach facilitates near-anatomical cup positioning without osteotomy but still carries risks. Further refinement, including shear wave elastography ultrasound monitoring of the ischial nerve, may reduce complications and improve the method.