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[Osteotomies of the pediatric hip joint]
Christian Ziegler1, Felix Endres2
1Klinik für Orthopädie und Unfallchirurgie, LMU-Klinikum, Muskuloskelettales Universitätszentrum München (MUM), Marchioninistraße 15, 81377, München, Deutschland. Christian.Ziegler@med.uni-muenchen.de.
Abstract:
Pelvic and femoral osteotomies, including soft-tissue balancing of the pediatric hip joint, aim to restore as physiological a geometry and biomechanics as possible in order to improve function and prevent wear. The main indications are developmental (DDH) and neurogenic dysplasia (NDH), Perthes disease (LCP), and femoral head slippage (ECF/SCFE). In childhood, acetabular roof plasty (PDP) and the Salter osteotomy (SIO) are the primary options; after growth is complete, triple pelvic osteotomy (TPO) and periacetabular osteotomy (PAO) are available, with the former potentially being performed even before skeletal maturity. If incongruity is present, shelf and Chiari osteotomies may be considered as salvage procedures. The outcome depends on correct indication, selection of the appropriate procedure, adequate consideration of soft tissue conditions, and structured follow-up care.
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