The Journal of Bone and Joint Surgery, Vol 57, Issue 5 626-631, Copyright © 1975 by Journal of Bone and Joint Surgery, Inc
Paralytic pelvic obliquity. Its prognosis and management and the development of a technique for full correction of the deformity
JP O'Brien, AP Dwyer and AR Hodgson
Thirty-nine patients with post-poliomyelitic scoliosis and pelvic obliquity
were treated and followed for up to four years. The dominant pathological
mechanism causing the pelvic obliquity was trunk-muscle imbalance. The
natural history of untreated pelvic obliquity is progression, leading
ultimately to dislocation of the hip. The functional abilities of the
patient are then severely restricted. Our aim in treatment was to obtain
the maximum possible correction of pelvic tilt and so to prevent
subluxation of the femoral head. Total correction was obtained in fifteen
patients; no loss of correction was seen in twenty-four patients. The best
results were achieved by preliminary traction, Dwyer instrumentation
distally to the fifth lumbar vertebra, and extensive posterior fusion
extendind distally to the sacrum.