Dataset Information

Modified Pemberton Pelvic Osteotomy Through Inner Ilium Approach for Treatment of Developmental Dysplasia of the Hip in Children.

ABSTRACT:

Introduction

Pemberton osteotomy is a widely used operation in developmental dysplasia of the hip (DDH). The traditional pelvic osteotomy was through outside of the ilium. However, in this study, we performed the pelvic osteotomy through the inner ilium approach.

Patients and methods

We retrospectively analyzed 79 patients diagnosed with DDH with open surgery in our hospital from March 2016 to May 2018. There were 39 patients who underwent outside ilium Pemberton osteotomy (PO) and 40 patients who underwent inner "L shaped" ilium Pemberton osteotomy (ILSO). Acetabular index (AI), center-edge angle of Wiberg (CE angle), Severin grading scoring system, postoperative avascular necrosis (AVN) by Kalamchi and McEwen classification, and McKay grading scoring system were used for evaluation.

Results

There was no significant difference between the PO group and ILSO group on AI (p = 0.476), CE angles (p = 0.225), avascular necrosis (Kalamchi and McEwen, p = 0.854), and hip function (McKay's, p = 0.444) on the final follow-up. There were significant differences in X-ray radiation (p < 0.001), blood loss (p = 0.011) and surgery time (p < 0.001).

Conclusion

Inner side ilium is a viable approach for Pemberton osteotomy of DDH in children with less X-ray radiation, and less blood loss and shorter surgery time.

Level of evidence

III.

Supplementary information

The online version contains supplementary material available at 10.1007/s43465-022-00676-7.

SUBMITTER: Su Y

PROVIDER: S-EPMC9385895 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

Modified Pemberton Pelvic Osteotomy Through Inner Ilium Approach for Treatment of Developmental Dysplasia of the Hip in Children.

Su Yuxi Y Nan Guoxin G

Indian journal of orthopaedics 20220627 9

<h4>Introduction</h4>Pemberton osteotomy is a widely used operation in developmental dysplasia of the hip (DDH). The traditional pelvic osteotomy was through outside of the ilium. However, in this study, we performed the pelvic osteotomy through the inner ilium approach.<h4>Patients and methods</h4>We retrospectively analyzed 79 patients diagnosed with DDH with open surgery in our hospital from March 2016 to May 2018. There were 39 patients who underwent outside ilium Pemberton osteotomy (PO) an ...[more]

PMID: 36052389

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Project description:BackgroundWhen reconstructing a hip with developmental dysplasia and high dislocation, sub-trochanteric shortening osteotomy is typically needed for placing the acetabular component in the appropriate anatomical position. However, the procedure can result in complications such as non-union of the osteotomy. We evaluated the contact area and the coincidence rate between the proximal and distal fragments at different femoral osteotomy levels and lengths. We then determined the optimal location of subtrochanteric femoral shortening transverse osteotomy in patients with unilateral Crowe type IV developmental dysplasia of the hip (DDH). The consistency between the proximal and distal segments was assessed as a possible predictive indicator of the union at the osteotomy site.MethodsWe retrospectively reviewed 57 patients with unilateral Crowe type IV?DDH who underwent X-ray imaging of both hip joints. We labelled the inner and outer diameters of the circular ring as N (mm) and M (mm), respectively. We defined the overlapped area between the proximal and distal ring as contact area S (mm2), and the ratio of contact area to distal ring area as coincidence rate R.ResultsN varied from 9.8-15.2?mm and M varied from 20.7-24?mm, both demonstrated a decreasing trend in the proximal to distal direction. At osteotomy lengths ranging from 0.5-2?cm, there were no differences in S between the different levels of osteotomy in each group. At osteotomy lengths ?2.5?cm, a significant higher coincidence rate was noted from 2?cm below the lesser trochanter to other positions below the level. At osteotomy lengths from 3 to 5.5?cm, a significantly higher coincidence rate was observed from the level of 1.5?cm below the lesser trochanter to other positions below the level.ConclusionsOur findings suggest that femoral shortening transverse osteotomy at the optimal subtrochanteric level can predictably increase the contact area and coincidence rate, which may contribute to the union at the osteotomy site. Considering the stability of the prostheses, it appears appropriate that osteotomy location should be shifted slightly distally.Trial registrationRetrospectively registered.

Dataset Information

Modified Pemberton Pelvic Osteotomy Through Inner Ilium Approach for Treatment of Developmental Dysplasia of the Hip in Children.

Introduction

Patients and methods

Results

Conclusion

Level of evidence

Supplementary information

Publications

Modified Pemberton Pelvic Osteotomy Through Inner Ilium Approach for Treatment of Developmental Dysplasia of the Hip in Children.

Similar Datasets

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