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Modified Angulated Innominate Osteotomy Using Cortical Screw Fixation for Developmental Dysplasia of the Hip: A
Yuta Tsukagoshi1, Hiroshi Kamada1, Yohei Tomaru1
1Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
JMA Journal
|August 11, 2026
Summary
This study introduces a modified angulated innominate osteotomy using cortical screws for developmental dysplasia of the hip. The technique demonstrated stable fixation and maintained correction, offering a safe and reliable alternative to traditional methods.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Surgical Innovation
Background:
- Salter innominate osteotomy (SIO) is standard for developmental dysplasia of the hip (DDH).
- Loss of correction due to insufficient fixation is a concern.
- Current angulated innominate osteotomy techniques often use Kirschner wires (K-wires), which may lack rigidity and cause complications.
Purpose of the Study:
- To evaluate the feasibility and safety of a modified angulated innominate osteotomy using 3.5-mm solid cortical screw fixation.
- To assess the stability and maintenance of correction in DDH treatment.
- To determine if screw fixation offers advantages over K-wire fixation.
Main Methods:
- A modified angulated innominate osteotomy technique was employed, eliminating the need for bone grafting.
- Provisional K-wire fixation was followed by exchange for 3.5-mm cortical screws without additional drilling.
- A retrospective review of seven consecutive female patients with DDH was conducted, analyzing radiographic parameters preoperatively and postoperatively at 6 months.
Main Results:
- The mean age at surgery was 5.0 years, with a mean operative time of 90 minutes.
- No perioperative complications, loss of correction, screw breakage, or implant failures were observed.
- Radiographic parameters showed maintained correction at 6 months postoperatively; full weight-bearing was achieved at a mean of 6.9 weeks.
Conclusions:
- Cortical screw fixation in angulated innominate osteotomy is feasible and safe.
- This technique provides stable fixation throughout the bone-healing phase.
- It appears to be a reliable and effective fixation option for DDH treatment without increasing surgical complexity.