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Putting on a hip distractor night strut

What is a hip distractor?

Children may have articulated hip distractions for conditions such as Perthes disease or Avascular Necrosis of the hip. The distractor moves the hip joint to encourage it to remodel.

One type of hip distraction fixator is without the night time extension strut.

image of hip distraction fixator, without the ‘night-time’ extension strut

It is important that you and your child are taught how to put on a night time extension strut.

The strut keeps your child’s hip in maximum extension overnight. This means it keeps your child’s hip in place after their exercise.

How do I put the night strut on?

The strut needs to be attached to the hip distractor near the hip, with the Sheffield fixator ring attached to the distal clamp near the knee.

The TSF strut has a number so you can check that the hip is locked at the same number (and the same extension) each night.

image of TSF strut, which is applied every night and removed in the morning

Ask your child to lie as flat as possible with a pillow under their head. Attached the strut by the bolts at their hip and their knee, as above.

Extend the strut as much as possible using the ratchet device, so that your child’s hip is in maximum extension. Make a note of the number on the struts scale so you can make sure it is set to the same extension every night.

You should only use the night-time extension strut every night until the hip distractor is removed or unless instructed by the child’s Consultant.


The Taylor spatial frame (TSF) strut needs to be put on last thing at night and removed first thing in the morning. This means your child can move freely throughout the day.

What equipment do we need?

Attachments to connect the night-time extension strut will be secured by the PLRS clinical nurse specialist or the orthopaedic surgeons. (These can be seen in the first picture).

  • a pair of 10mm spanners
  • 1 TSF strut (of the appropriate length)
  • 2 TSF bolts
  • 2 washers (usually one thick and one thin, or a combination)

You will be given these items to use with your child’s strut.

The strut is attached to the existing attachments, using a bolt and appropriate washer at either end.

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: PLR10

Resource Type: Article

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