[Salter's innominate osteotomy. 20 years later...]

Area of Science:

• Orthopaedic Surgery
• Pediatric Orthopaedics
• Hip Dysplasia Treatment

Background:

• Congenital hip dislocation (CHD) often requires surgical intervention.
• Late diagnosis of CHD can complicate treatment outcomes.
• Persistent hip subluxation may necessitate corrective osteotomies.

Purpose of the Study:

• To evaluate the long-term outcomes of innominate osteotomies for treating hip dysplasia.
• To assess functional and radiological results after surgical correction.
• To identify factors influencing the success of innominate osteotomies.

Main Methods:

• Retrospective review of 19 innominate osteotomies with an average 20.6-year follow-up.
• Procedures included combined open reduction and pelvic osteotomies, pelvic and femoral varisation derotation osteotomies, and isolated pelvic osteotomies.
• Patient data included age at diagnosis and operation, surgical procedures, Charnley hip scores, and radiographic measurements (CE angle, AC angle, anterior coverage).

Main Results:

• 15 hips were pain-free; 4 had mechanical pain.
• Radiographic evaluation showed average CE angle of 28.5°, AC angle of 16°, and anterior coverage of 40°.
• 6 hips (33%) required reoperation due to insufficient coverage, technical errors, or osteonecrosis; 4 hips showed arthritic changes or femoral head deformation.

Conclusions:

• Innominate osteotomies can provide good functional outcomes for hip dysplasia.
• A significant proportion (1/3 to 1/2) experience long-term radiological problems.
• Optimal results depend on adherence to surgical techniques, early diagnosis, and avoiding osteonecrosis.