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Percutaneous innominate pelvic osteotomy without the use of bone graft for femoral head coverage in children 2–8 years of age Sanchez Mesa, Pedro Antonio; Yamhure, Fernando Helo
Percutaneous innominate pelvic osteotomy without the use of bone graft for femoral head coverage in children 2–8 years of age.
Journal of Pediatric Orthopaedics B:
May 2010 - Volume 19 - Issue 3 - pp 256-263
doi: 10.1097/BPB.0b013e328331c3c3
Hip
Abstract
Percutaneous innominate pelvic osteotomy without the use of bone graft as treatment for hip diseases is proposed as another tool to handle this pathology, which occurs frequently in our area, without changing postural correction at the level of the pelvis by secondary transiliac lengthening through an unilateral iliac bone graft at the lower extremity. This technique was developed by biomechanical studies in corpses and was later performed on children. This was a prospective, multicentric, longitudinal study of a case series in children between 2 and 8 years of age with developmental hip dysplasia, Legg–Calve–Perthes disease, aseptic or avascular necrosis, congenital or acquired lesions of the femoral head having obtained previous consent from the parents. In 121 patients with increases in femoral head coverage in a concentric hip joint, the average follow-up period was 4.1 years (range 6 months to 5 years). The vertical-center-anterior angle of Lequesne and the center-edge angle of Wiberg, both of which showed significant improvement in the coverage of the femoral head with an average of acetabular presurgical index of 38.2° (P=0.002) and a postsurgical average of 19.8° (P=0.003), angles of lateral uncovering of the femoral head of 12.3° (P=0.0019) and a postsurgical angle of 23.2° (P=0.004). The registered complications were 2.7% (P=0.047). The results offer many advantages over the current treatments on handling congenital diseases or acquired diseases of the hip and can indicate an alternative to the other methods of treatment which is possibly less aggressive and with a better future for the patient.
© 2010 Lippincott Williams & Wilkins, Inc.
Journal of Pediatric Orthopaedics B:
May 2010 - Volume 19 - Issue 3 - pp 256-263
doi: 10.1097/BPB.0b013e328331c3c3
Hip
Abstract
Percutaneous innominate pelvic osteotomy without the use of bone graft as treatment for hip diseases is proposed as another tool to handle this pathology, which occurs frequently in our area, without changing postural correction at the level of the pelvis by secondary transiliac lengthening through an unilateral iliac bone graft at the lower extremity. This technique was developed by biomechanical studies in corpses and was later performed on children. This was a prospective, multicentric, longitudinal study of a case series in children between 2 and 8 years of age with developmental hip dysplasia, Legg–Calve–Perthes disease, aseptic or avascular necrosis, congenital or acquired lesions of the femoral head having obtained previous consent from the parents. In 121 patients with increases in femoral head coverage in a concentric hip joint, the average follow-up period was 4.1 years (range 6 months to 5 years). The vertical-center-anterior angle of Lequesne and the center-edge angle of Wiberg, both of which showed significant improvement in the coverage of the femoral head with an average of acetabular presurgical index of 38.2° (P=0.002) and a postsurgical average of 19.8° (P=0.003), angles of lateral uncovering of the femoral head of 12.3° (P=0.0019) and a postsurgical angle of 23.2° (P=0.004). The registered complications were 2.7% (P=0.047). The results offer many advantages over the current treatments on handling congenital diseases or acquired diseases of the hip and can indicate an alternative to the other methods of treatment which is possibly less aggressive and with a better future for the patient.
© 2010 Lippincott Williams & Wilkins, Inc.
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