A new technique of triple pelvic osteotomy with simultaneous reconstruction of the hip pelvic and femoral components

Abstract

A new technique of triple pelvic osteotomy has been developed for treating children with the hip congenital pathology. Ischial bone transection is made from the interfragmental approach after femoral osteotomy performance. In this case no additional approach to it is required, thereby decreasing the intervention invasiveness. The pubic bone should be transected at the base, the iliac one – transversely or semicircularly above the lower anterior iliac spine. The bone fragment resected during femoral osteotomy is used for defect filling and fixation of the mobilized acetabular fragment in the supraacetabular area. The technique proposed has been applied to 13 children at the age of 9-14 years in 14 joints for pathology of dysplastic genesis (in 9 joints of 8 patients), for osteomyelitis consequences (2), aseptic necrosis outcome after conservative treatment of the hip congenital dislocation (1), Perthes disease (1), the hip paralytic dislocation (1). Follow-up after surgery was from 6 months to 6 years. Positive clinical-and-roentgenological dynamics has been observed while studying the results obtained, as well as congruence and stability of the hip has been achieved, injuries of neurovascular masses have been noted in no cases, complete bone covering of the femoral head has been got. The technique proposed allows to reduce technical difficulties and secure surgical intervention for one-stage reconstruction of pelvic and femoral components.