title: An effective treatment for hip instabilities: pelvic support osteotomy and femoral lengthening.
abstract: OBJECTIVE
  In this study, we evaluated the effectiveness of pelvic support osteotomy treatment in hip instabilities due to various etiologies.
  
  
  METHODS
  We retrospectively evaluated 21 hips of 20 patients that underwent pelvic support osteotomy between 2005 and 2007. Hip instability was caused by a neglected congenital dislocation of the hip in 12 of the patients (13 hips), by septic arthritis in 7 and by an unsuccessful total hip arthroplasty due to infection in the last patient. The mean age of the patients was 22.6 (range: 12 to 34) years. Osteotomy sites were fixed using monolateral external fixators in 11 patients, Ilizarov circular fixators in 8, and locking plates for both hips of the remaining patient. The mean follow-up period was 33.45 (range: 16 to 45) months.
  
  
  RESULTS
  The mean Harris score increased from 48.3 preoperatively to 80.1 postoperatively. Preoperative mean limb length discrepancy was 53.3 mm and mean proximal migration was 42.9 mm. Residual limb length discrepancy was reduced to 16 mm after an average lengthening of 63.3. The preoperative Trendelenburg gait disappeared completely in 13 of 21 hips and was improved in 8 hips. Sixteen of the 20 patients (17 hips) expressed satisfaction with the operation.
  
  
  CONCLUSIONS
  Pelvic support osteotomy is a good treatment option to overcome hip instability as it improves pain and equalizes limb length.
authors.affiliation: Department of Orthopeadics and Traumatology, Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey. sarper154@yahoo.com
authors.forename: Sarper
authors.initials: S
authors.lastname: Gürsu
authors.forename: Bilal
authors.initials: B
authors.lastname: Demir
authors.forename: Timur
authors.initials: T
authors.lastname: Yildirim
authors.forename: Turgay
authors.initials: T
authors.lastname: Er
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Bursali
authors.forename: Vedat
authors.initials: V
authors.lastname: Sahin
mesh_terms: D000293:Adolescent; D000328:Adult; D001170:Arthritis, Infectious / Q000150:complications; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D001852:Bone Lengthening; D002648:Child; D005260:Female; D005269:Femur / Q000601:surgery*; D006618:Hip Dislocation, Congenital / Q000150:complications; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D010027:Osteotomy; D055815:Young Adult