[Salter's innominate osteotomy. 20 years later...].
This is a retrospective review of nineteen innominate osteotomies with an average follow-up of 20, 6 years. These osteotomies were done mainly for treatment of late diagnosed congenital hip dislocation, or occasionally for persistent subluxation after orthopaedic treatment. The mean age at diagnosis was 2 years 2 months, at operation 3 years 5 months. We performed eight combined open reduction and pelvic osteotomies, eight associated pelvic and femoral varisation derotation osteotomies and only 3 isolated pelvic osteotomies. At follow-up the Charnley hip's score is 5.7 for pain; 5.4 for gait and performance, 5.6 for mobility. We found 15 hips without any significant pain and only 4 hips with mechanical pain. The Xray evaluation shows an average CE angle at 28.5 degrees, AC angle at 16 degrees and anterior coverage on "faux profil de Lequesne" at 40 degrees; 4 hips show arthritic changes, 4 others had important deformation of the head of the femur, but without diminution of the height of articular space. 6 hips (1/3) in 4 patients must be reoperated in adolescence because insufficiency of coverage of the head of the femur: 3 because technical errors and 3 because osteonecrosis with progressive cervicocephalic valgus. This historical serie with a very important follow-up, demonstrate that between 1/3 and 1/2 of cases have some kind of problems mainly radiological. The quality of results depends on the respect of the conditions and technique described by Salter, early diagnosis and absence of osteonecrosis eventually caused by prealable orthopaedic treatment.
Dutoit
M
M
Hôpital Orthopédique de la Suisse Romande, Lausanne.
Moulin
P
P
Morscher
E
E
D000203:Activities of Daily Living; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D011183:Postoperative Complications / Q000145:classification / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies
Ostéotomie innominée de Salter 20 ans après...