Innominate Osteotomy in the Treatment of Congenital Dislocation and Subluxation of the Hip

Salter, Robert B.

doi:10.1302/0301-620x.43b3.518

Cited by 553 publications

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“…The procedures were performed as originally described by Salter [11] or Pemberton [9]. An anterior iliofemoral approach was used and an iliopsoas tenotomy over the rim was routinely performed.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of Acetabular Anterior Coverage After Salter Osteotomy and Pemberton Acetabuloplasty: A Long-term Followup

Wang

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background The Salter osteotomy and Pemberton acetabuloplasty are common procedures for a deficient acetabulum in patients with developmental dysplasia of the hip. However, the degree of increasing retroversion and anterior acetabular coverage of these two procedures remains unanswered. Questions/purposes The purpose of this study is to show the change in anterior coverage and relevant parameters in measuring pain and function among patients who have undergone either a Salter osteotomy or Pemberton acetabuloplasty. Methods Forty-two patients who underwent either a Salter or Pemberton procedure at one institution between January 1981 and December 2000 and were available for followup at least 10 years later (mean, 18 years; range, 12-28 years) were evaluated retrospectively. This represented 12% of the Salter and Pemberton procedures performed in patients between 12 and 36 months old at our institution during the study period. We measured verticalcenter-anterior margin angle, anterior acetabular head index, and weightbearing zone acetabular index, and we made comparisons using the radiographic parameter ratio (the division of each radiographic measurement of the operative side by that of the nonoperated side). All patients completed SF-36 and Harris hip score questionnaires at followup. Results In the Salter group, there were no differences in vertical-center-anterior margin angle, anterior acetabular head index, or weightbearing zone acetabular index. In the Pemberton group, there was no difference in vertical-center-anterior margin angle or anterior acetabular head index, but the weightbearing zone acetabular index decreased, suggesting increased anterior acetabular coverage (surgically treated side, 6 [95% CI, 4.84, 7.16]; nonoperated side, 12 [95% CI, 10.07, 13.39]; p \ 0.001). Compared with that in the Salter group, the weightbearing zone acetabular index ratio was smaller in the Pemberton group, which means more acquired anterior coverage after a Pemberton acetabuloplasty (Salter procedure, 0.94 [95% CI, 0.70, 1.17], Pemberton procedure, 0.53 [95% CI, 0.40, 0.65]; p \ 0.001). Three patients in the Pemberton group had an anterior impingement sign at followup, whereas none in the Salter group did. The SF-36 and Harris hip scores were good and showed no differences between the two groups.

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Section: Methodsmentioning

confidence: 99%

“…A Salter osteotomy is a complete osteotomy to redirect the entire acetabulum to obtain the best possible femoral head-acetabulum relationship [11]. A Pemberton acetabuloplasty is an incomplete osteotomy to modify the shape of the acetabulum by hinging at the horizontal branch of the triradiate cartilage [9].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Acetabular Anterior Coverage After Salter Osteotomy and Pemberton Acetabuloplasty: A Long-term Followup

Wang

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Many surgical procedures have been described for the management of these late-presenting cases [1]. Salter [2], back in 1961, described one of the most commonly used osteotomies. We also found a growing interest in the iliac osteotomy described by Dega in Poland in 1969 [3], as an acetabuloplasty that changes the acetabular configuration and its inclination.…”

Section: Introductionmentioning

confidence: 99%

The effect of Dega acetabuloplasty and Salter innominate osteotomy on acetabular remodeling monitored by the acetabular index in walking DDH patients between 2 and 6 years of age: Short- to middle-term follow-up

El-Sayed

Ahmed

Fathy

et al. 2012

Journal of Children's Orthopaedics

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Introduction The surgical management of neglected developmental dysplasia of the hip (DDH) in walking children has always been a challenge to orthopedic surgeons. The aim of this study was to evaluate the short-to middle-term clinical and radiographic results of the management of DDH. Patients and methods Patients less than 6 years old using two of the most commonly used osteotomies, namely, Salter innominate osteotomy and the Dega acetabuloplasty. Special attention was paid to acetabular remodeling after concentric reduction, which was monitored by the acetabular index, that, in turn, was measured preoperatively, immediately postoperatively, every 6 months, and at the final follow-up examination. Results The final overall clinical end results were favorable (excellent or good) in 93 hips (85.3 %). There was a marked improvement of the acetabular coverage during the follow-up period, which proved the good remodeling potential of the acetabulum for this particular age group after concentric reduction was achieved and maintained. Conclusion Both osteotomy types were found to be adequate for the management of neglected walking DDH patients under the age of 6 years.

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“…Numerous surgical procedures for DDH have been described [5,6,23,30]. Most surgeons are familiar with procedures described by Salter [22] in 1961 and by Pemberton [17] in 1965. Salter and Dubos [22,23] described a transiliac innominate osteotomy in which the lower quarter of the pelvis is rotated forward, downward, and outward, that reoriented the acetabulum anterolaterally, thereby increasing the coverage of the femoral head.…”

Section: Introductionmentioning

confidence: 99%

“…Most surgeons are familiar with procedures described by Salter [22] in 1961 and by Pemberton [17] in 1965. Salter and Dubos [22,23] described a transiliac innominate osteotomy in which the lower quarter of the pelvis is rotated forward, downward, and outward, that reoriented the acetabulum anterolaterally, thereby increasing the coverage of the femoral head. Pemberton [17] described an acetabuloplasty in which the ilial osteotomy ends at the posterior limb of the triradiate cartilage and the anterolateral rim of the acetabulum is hinged downward and laterally.…”

Section: Introductionmentioning

confidence: 99%

How Are Outcomes Affected by Combining the Pemberton and Salter Osteotomies?

Bursalı¹,

Tonbul²

2008

Clinical Orthopaedics &Amp; Related Research

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The Pembersal operation combines features of the Pemberton and Salter osteotomies. Results have usually been reported in patients with dysplasia but without frank dislocation. We asked if the following factors influence the outcome of the Pembersal operation in patients with dislocated hips: triradiate cartilage damage causing early closure; the acetabular index improvement; and the age of the patient at time of operation. We assessed triradiate cartilage damage, a modified McKay clinical classification, acetabular index, center-edge angles, Reimers index, acetabular depth-to-width ratios, Severin classification and Tönnis grading of 33 patients (44 hips) have been evaluated in this retrospective study. The mean age at surgery was 5 years (range, 1.5-14 years). The minimum followup was 5 years (mean, 10.5 years; range, 5-17 years). Preoperatively, three (7%) hips were Tönnis Grade 2, 10 (23%) were Grade 3, and 31 (70%) were Grade 4. Eight (18%) hips were Severin Class 1, 32 (73%) Class 2, and four (9%) were Class 3. According to McKay's criteria satisfactory results with a rate of 76% were obtained.

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Innominate Osteotomy in the Treatment of Congenital Dislocation and Subluxation of the Hip

Cited by 553 publications

References 0 publications

Comparison of Acetabular Anterior Coverage After Salter Osteotomy and Pemberton Acetabuloplasty: A Long-term Followup

Comparison of Acetabular Anterior Coverage After Salter Osteotomy and Pemberton Acetabuloplasty: A Long-term Followup

The effect of Dega acetabuloplasty and Salter innominate osteotomy on acetabular remodeling monitored by the acetabular index in walking DDH patients between 2 and 6 years of age: Short- to middle-term follow-up

How Are Outcomes Affected by Combining the Pemberton and Salter Osteotomies?

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