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[Modified PemberSal osteotomy technique with lyophilized human allograft].

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  • 1Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.

Operative Orthopadie Und Traumatologie
|September 16, 2016
PubMed
Summary

The PemberSal osteotomy improves femoral head coverage by rotating the acetabular roof. This surgical technique is suitable for patients with open growth plates, addressing hip dysplasia and Legg-Calvé-Perthes disease.

Keywords:
AcetabuloplastyCongenital hip dislocationHip dysplasiaLegg–Calvé–Perthes diseasePerthes disease

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Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Hip reconstruction

Background:

  • Developmental dysplasia and dislocation of the hip require improved femoral head coverage.
  • Legg-Calvé-Perthes disease necessitates enhanced sphericity and containment of the femoral head.
  • PemberSal osteotomy is a specific acetabuloplasty technique indicated for patients with open epiphyseal growth plates.

Purpose of the Study:

  • To describe the PemberSal osteotomy technique for improving femoral head coverage.
  • To outline the indications and contraindications for this acetabuloplasty procedure.
  • To detail the surgical technique, postoperative management, and follow-up protocols.

Main Methods:

  • The PemberSal osteotomy involves creating an osteotomy from the iliac bone to the acetabular growth plate cartilage.
  • Controlled fracture of the cancellous bone allows for ventrocaudal rotation of the acetabular roof.
  • An allogenic bone-wedge is used to refill and stabilize the osteotomy site, secured with a resorbable screw or Kirschner wire.

Main Results:

  • This technique enables ventral and lateral rotation of the acetabular roof, enhancing femoral head coverage.
  • It can be combined with other procedures like femoral osteotomy and open reduction for complex hip conditions.
  • The method allows for intricate acetabular roof reconstructions, including modifications of the Rejholec technique.

Conclusions:

  • PemberSal osteotomy is an effective method for improving femoral head coverage in pediatric hip conditions with open growth plates.
  • Careful patient selection, considering contraindications such as bleeding tendencies or anesthetic risks, is crucial.
  • Postoperative immobilization with a spica cast followed by physical therapy ensures optimal recovery and radiographic outcomes.