DDH | Perthes Disease | SCFE | FEMORAL OSTEOTOMY
Pelvic Osteotomy is a surgical procedure where parts of the pelvis are divided and rotated to provide better cover over the head of the femur, to improve pain and stability. They are used often in the management of Hip Dysplasia, in young children through to adults. The type of osteotomy changes as the child grows.
Pelvic Osteotomies can be divided into: 1) change the shape of the acetabulum 2) change the orientation of the acetabulum and 3) salvage procedures
In children over 18 months with late presentation hip dislocations, the open reduction of the hip is accompanied by a pelvic osteotomy to improve the cover of the hip and reduce the risk of the hip re-dislocating. Pemberton and Dega are types of osteotomies used in this situation.
Hip dysplasia in the older child is managed with the Salter Osteotomy, Triple pelvic osteotomy or Periacetabular Osteotomy
Triple Pelvic Osteotomy and Periacetabular Osteotomies are the osteotomy of choice in adolescent and young adult hip dysplasia. Patients present with pain, usually in the groin and a limp. Secondary problems such as labral tears or degenerative changes are the cause of increasing pain. Instability can occur with increased dysplasia or with ligamentous laxity. Imaging with Standing Xray, False Profile lateral, True lateral give most of the information required about the bony anatomy. MRI gives further information about the labrum and the condition of the articular cartilage.
Examples