title: The comparative, long-term effect of the Salter osteotomy and Pemberton acetabuloplasty on pelvic height, scoliosis and functional outcome.
abstract: OBJECTIVE
  This study compared the long-term results following Salter osteotomy and Pemberton acetabuloplasty in children with developmental dysplasia of the hip (DDH). We assessed if there was a greater increase in pelvic height following the Salter osteotomy, and if this had a continued effect on pelvic tilt, lumbar curvature or functional outcomes.
  
  
  METHODS
  We reviewed 42 children at more than ten years post-operatively following a unilateral Salter osteotomy or Pemberton acetabuloplasty. We measured the increase in pelvic height and the iliac crest tilt and sacral tilt at the most recent review and at an earlier review point in the first decade of follow-up. We measured the lumbar Cobb angle and the Short Form-36 (SF-36) and Harris hip scores were collected at the most recent review.
  
  
  RESULTS
  During the first decade of follow-up, there was a greater increase in pelvic height in the children who had a Salter osteotomy (Salter, 10.1%; Pemberton, 4.3%, p < 0.001). The difference in the increase in pelvic height was insignificant at the most recent review (Salter, 4.4%; Pemberton, 3.1%, p = 0.249). There was no significant difference between the two groups for the lumbar Cobb angle, (Salter, 3.1°; Pemberton, 3.3°, p = 0.906). A coronal lumbar curve was seen in 41 children (97%), 30 of these had a compensatory curve. Sacral tilt was the radiographic parameter for pelvic imbalance that correlated most with the lumbar Cobb angle (Pearson correlation co-efficient 0.59). The Harris hip score and SF-36 were good and showed no differences between the two groups.
  
  
  CONCLUSIONS
  In the long-term, we found no difference in the functional results or pelvic imbalance between Salter osteotomy and Pemberton acetabuloplasty in the management of children with DDH. Cite this article: Bone Joint J 2016;98-B:1145-50.
authors.affiliation: Department of Orthopedic Surgery, National Taiwan University Hospital, No.7, Chung Shan S. Rd, Zhongzheng Dist, Taipei City, 10002, Taiwan.
authors.forename: C-W
authors.initials: CW
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, National Taiwan University Hospital, No.7, Chung Shan S. Rd, Zhongzheng Dist, Taipei City, 10002, Taiwan.
authors.forename: T-M
authors.initials: TM
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, National Taiwan University Hospital, No.7, Chung Shan S. Rd, Zhongzheng Dist, Taipei City, 10002, Taiwan.
authors.forename: K-W
authors.initials: KW
authors.lastname: Wu
authors.affiliation: Department of Orthopedic Surgery, National Taiwan University Hospital, No.7, Chung Shan S. Rd, Zhongzheng Dist, Taipei City, 10002, Taiwan.
authors.forename: S-C
authors.initials: SC
authors.lastname: Huang
authors.affiliation: Taipei Medical University, No.250, Wuxing Street, Taipei City 11031, Taiwan.
authors.forename: K N
authors.initials: KN
authors.lastname: Kuo
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D001827:Body Height / Q000502:physiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007870:Leg Length Inequality / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D010027:Osteotomy / Q000379:methods*; D010384:Pelvic Bones / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D012600:Scoliosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*
keywords: Iliac crest tilt; Lumbar scoliosis; Pelvic height; Pemberton acetabuloplasty; Sacral tilt; Salter osteotomy