Complete Transiliac Pelvic Osteotomy for Patients with Developmental Dysplasia of the Hip without Internal Fixation

Abstract

Several problems are encountered with pelvic osteotomy in hip dysplasia including insufficient coverage, avascular necrosis, graft instability and fixation of secondary bone grafts. We evaluated results of pelvic osteotomy in 4-8 year olds in our institution. 44 cases of developmental dysplasia of the hip between 1994 and 1999 were reviewed. 14 hips in 12 patients were treated with a step-cut osteotomy and the results are discussed. The mean age was 5.6 (range: 4-8) years, and mean follow up was 87.7 months (60-120). The patients were followed up according to the Severin clinical assessment criteria, and their radiological findings were evaluated and classified in accordance with the Tonnis criteria. Radiologically, a marked correction was obtained in center-edge angle, which was increased to 22.30 from the preoperative value of -11.20. No graft shift or loss was observed in any cases. There was also no loss in coverage achieved by surgical intervention. Coxofemoral positioning was found to be normal in eighty percent of cases. 8% of cases had avascular necrosis. Full range of hip motion was achieved in 84% of cases, and 84% of cases exhibited negative Trendelenburg's sign. The modified osteotomy we describe eliminated the need for fixation and secondary surgery. Graft stability and bone conservation were achieved.

SUFE and the internet: are healthcare information websites accessible to parents?

“… 1 2 SUFE can be categorised as a Salter-Harris type fracture, 3 characterised by the slippage of the proximal femoral metaphysis anteriorly and superiorly relative to the epiphysis. 4 The epiphysial plate is usually widened due to the presence of an unusually large hypertrophic zone. This increased area of hypertrophy effects the normal cartilaginous architecture, making it less organised and can result in weak areas, where slippage can occur.…”

Slipped Upper Femoral Epiphysis: Are We Missing the Point?

“…SUFE is also known as a slipped capital femoral epiphysis. The average age of its manifestation is 13.4 years in boys and 12.2 years in girls [ 1 ]. It has a higher incidence in boys, especially in obese children.…”

Hip International in 2010 and Beyond

“…Metal on metal resurfacing (12,13,14,15,16,17,18) remains topical, and the associated issues relating to biomechanics (19,20) and blood supply (21). Advances in the early and late management of developmental dysplasia have been addressed (22,23,24,25,26), and new methods of imaging for this condition and femoro-acetabular impingement have been evaluated (27,28). In addition, numerous and diverse clinical series and case reports have been published during the last 12 months.…”