The Journal of Bone and Joint Surgery, Vol 67, Issue 6 842-850, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
A combination pelvic osteotomy for acetabular dysplasia in children
PC Perlik, GW Westin and RL Marafioti
Several surgical procedures have been devised to increase acetabular
coverage of the femoral head in children with dysplasia of the hip. In this
report we describe an acetabuloplasty that combines the key aspects of the
Pemberton and Salter osteotomies. It has been used at the Los Angeles Unit
of the Shriners Hospital for Crippled Children since the late 1960's. To
assess the results of this combination procedure, fifty hips in forty-four
children were evaluated at an average of six years postoperatively. The
average age at operation was 7.3 years, and 62 per cent of the patients had
had prior surgery. Clinically, thirty-two hips in which there had been no
or slight symptoms preoperatively remained unchanged, twelve that had had
preoperative limitations improved, and six showed some deterioration in
terms of slight loss of motion, mild pain, and a limp.
Roentgenographically, acetabular dysplasia (as measured by the acetabular
index and by the center-edge angle of Wiberg) improved in more than 90 per
cent of the hips. The roentgenographic results were comparable with those
obtained by innominate or pericapsular osteotomy. The combination osteotomy
has the advantages of both the Pemberton procedure and the Salter operation
and proved to be an excellent surgical procedure for older children whose
acetabular development did not progress as well as was expected.