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AN “ALMOST” PERCUTANEOUS TRIPLE PELVIC OSTEOTOMY TO OBTAIN FEMORAL HEAD COVERAGE IN CHILDREN 6–14 YEARS OF AGE



Abstract

Purpose: To describe a simple method for performing pelvic osteotomies in children that will obtain appropriate femoral head coverage.

Method: The necessary femoral head coverage was preoperatively predicted by assessing the acetabular, Wiberg, and Lequesne angles, and by 3-D CAT scan evaluations of each hip. Postoperative results were evaluated in a similar manner and compared with the preoperative findings. An “almost” percutaneous triple pelvic osteotomy was performed using an adductor incision and a transverse incision.

Results: In spite of the theoretical restrictions in this age group to acetabular movement, i.e. rigid triradiate cartilage, stiff symphysis pubis and rigid sacrospinous and sacrotuberous ligaments, adequate coverage of the femoral head was attained with the described technique.

Conclusion: If a pelvic osteotomy is being considered to better stabilize a child’s hip due to a condition such as Legg-Calve-Perthes disease, hip dysplasia, a deformed femoral neck secondary to slipped capital femoral epiphysis or femoral head necrosis, the “almost” percutaneous triple osteotomy has a decided advantage over other well described pelvic osteotomies since it is simpler to perform and sufficiently covers the femoral head.

The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.