MODIFIED SALTER PELVIC OSTEOTOMY FOR THE DDH TREATMENT

Three pelvic osteotomies (Salter, Dega, Pemberton) are widely used in walking patients under seven years old for DDH treatment. We’ve proposed a modified Salter Pelvic Osteotomy (SPO), which has the advantages of the abovementioned osteotomies.

Methods:

Short- and mid-term results were assessed in 19 patients after the modified SPO application. Patients were examined before and after the surgery, at 6 months postoperatively, and at follow-up.

Results:

Acetabular Index (AI) before the surgery was 39.5 ± 7 °; after the surgery - 24.4 ± 5.5 °, at 6 months - 20.4 ± 5 ° (9-28), at follow-up - 14.5 ± 4 °; AI correction - 14.9 ± 5.5 °. Lateral Centre-Edge Angle at follow-up - 22.7 ± 4.7 °. Clinical results at follow-up were I / II McKay grade in 18 patients (94.7%); radiological results were I / II Severin class in 18 patients (94.7%).

Conclusion:

Modified SPO improves the FH coverage in any direction; results after modified SPO are excellent and good in most patients. Level of Evidence IV; Case Series.

Keywords:
Developmental Dysplasia of the Hip; Pelvic Region; Osteotomy; Evaluation of Results of Therapeutic Interventions

Severin	McKay	AVN	CEA	f-up	6m	diff	aft	bef	Tonnis	f-up	surgery	age	side	sex	Nº
1	1	1	28	6	20	10	22	32	2	5	SPO+FVDO	3	L	F	1
1	1		27	12	16	12	22	34	2	2	SPO+FVDO	6	L	F	2
2	2	1	23	16	20	18	25	43	4	1	OSS	3	L	F	3
1	1		29	11	15	14	15	30	2	2	SPO+FVDO	4	L	F	4
1	1	4	26	12	23	17	26	43	4	3	OSS	6	L	F	5
1	1	4	23	13	26	11	26	37	4	3	OSS	6	R	F	6
3	3		15	20	25	22	31	53	4	1	OSS	2	L	F	7
1	1	1	22	9	9	28	15	43	4	2	OSS	4	L	F	8
1	1		26	18	23	9	27	36	4	2	OSS	6	L	F	9
2	2	1	19	18	23	15	33	48	4	1	OSS	4	R	F	10
1	2		20	16	22	15	27	42	4	1	OSS	3	R	F	11
1	2		16	14	21	8	23	31	4	1	SPO+FVDO	2	R	F	12
1	1	3	27	11	25	14	28	42	4	5	OSS	4	L	F	13
1	1		26	14	12	16	15	31	2	4	SPO+FVDO	2	L	F	14
1	1		27	14	16	11	21	32	2	5	SPO+FVDO	2	R	F	15
1	1	1	24	16	22	13	30	43	3	3	SPO+FVDO	3	L	M	16
2	2		15	23	28	9	31	42	4	4	OSS	2	R	F	17
1	1		24	17	24	26	26	52	4	5	OSS	3	R	F	18
2	2		15	15	18	16	20	36	2	1	SPO+FVDO	3	L	F	19

Author (reference)	Results
	Radiological	Clinical
Esmaeilnejad- Ganji, S. M. ¹1 Esmaeilnejad-Ganji SM, Esmaeilnejad-Ganji SMR, Zamani M, Alitaleshi HA. Newly Modified Salter Osteotomy Technique for Treatment of Developmental Dysplasia of Hip That Is Associated with Decrease in Pressure on Femoral Head and Triradiate Cartilage. Biomed Res Int. 2019:6021271.	Severin І\ІІ - 96.7%; AI - 11.24; CEA - 39.1	Mac-kay І\ІІ - 94.5%
Gurger, M. ²2 Gurger M, Demir S, Yilmaz M, Once G. Salter osteotomy without open reduction in the Tönnis type II developmental hip dysplasia: A retrospective clinical study. J Orthop Surg (Hong Kong). 2019;27(1):2309499019835572.	Severin І\ІІ – 100%; AI -18.0; CEA -39.0	Mac-kay І\ІІ – 100%
Bhuyan BK ³3 Bhuyan BK. Outcome of one-stage treatment of developmental dysplasia of hip in older children. Indian J Orthop. 2012;46(5):548-55.	Severin І\ІІ - 83.4%; AI - 21°; CEA - 23.5°	Mac-kay І\ІІ - 90%
Ahmed, E. ¹³13 Ahmed E, Mohamed AH, Wael H. Surgical treatment of the late - presen- ting developmental dislocation of the hip after walking age. Acta Ortop Bras. 2013;21(5):276-80.	Severin І\ІІ – 76.8%; AI - 19°; CEA - 26°	Mac-kay І\ІІ – 80.8%
Da Rocha, V. L. ¹⁴14 da Rocha VL, Marques GL, da Silva LJ, di Macedo Bernardes TA, de Moraes FB. Clinical and radiographic medium-term evaluation on patients with developmental dysplasia of the hip, who were submitted to open reduction, capsuloplasty and Salter osteotomy. Rev Bras Ortop. 2014;49(1):51-5.	Severin І\ІІ - 69.2%, AI – 18.5°	Dutoit ( excellent +good) – 92.3%
Chen Q ¹⁵15 Chen Q, Deng Y, Fang B. Outcome of one-stage surgical treatment of developmental dysplasia of the hip in children from 1.5 to 6 years old. A retrospective study. Acta Orthop Belg. 2015;81(3):375-83.	Severin І\ІІ - 83.3%; AI - 21 2°; CEA - 23.5°	Mac-kay І\ІІ – 90%
Xie X ¹⁶16 Xie X, Tang X, Jiang X, Peng M, Liu L. Application of absorbable pins for reconstructing pelvic stability in Salter innominate. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013;27(4):428-31F.	Severin І\ІІ - 97.6%	Mac-kay І\ІІ - 98.3%
Ahmed K ¹⁷17 Kandil AE, Saeed A, El-Barbary H, Hegazi M, El-Sobky M. Salter versus Dega osteotomy after open reduction of developmental dysplasia of the hip in young children. Egypt Orthop J. 2013;48(1):80-7.	Severin І\ІІ - 90%	Mac-kay І\ІІ - 89.5%
Bayhan, I. A. ¹⁸18 Bayhan IA, Beng K, Yildirim T, Akpinar E, Ozcan C, Yagmurlu F. Comparison of Salter osteotomy and Tonnis lateral acetabuloplasty with simultaneous open reduction for the treatment of developmental dysplasia of the hip: midterm results. J Pediatr Orthop B. 2016;25(6):493-8.	Severin І\ІІ – 92%; AI - 12 8°; CEA - 30 9°	Mac-kay І\ІІ - 92%
Morin, C. ¹⁹19 Morin C, Bisogno J, Kulkarni S, Morel G. Treatment of late-presenting developmental dislocation of the hip by progressive orthopaedic reduction and innominate osteotomy. Our results with more than 30 years of follow up. J Child Orthop. 2011;5(4):251-60.	Severin І\ІІ – 96.3%; AI -12 8°; CEA - 29°	Harris hip score - 94.5
Da Rocha, V. L. ²⁰20 da Rocha VL, Thomé AL, da Silva Castro DL, de Oliveira LZ, de Moraes FB. Clinical And Radiological Evaluation On Developmental Hip Dysplasia After Salter And Ombrédanne Procedure. Rev Bras Ortop. 2015;46(6):650-5.	Severin І\ІІ – 88.9%; CEA - 20.7 5.02°	Dutoit (excellent+good) –83.3%
Our modification	Severin І\ІІ – 94.7%; AI – 14.5 4°; CEA–22.7 4.7°	Mac-kay І\ІІ – 94.7%

ATHA EDITORA Rua: Machado Bittencourt, 190, 4º andar - Vila Mariana - São Paulo Capital - CEP 04044-000, Telefone: 55-11-5087-9502 - São Paulo - SP - Brazil
E-mail: actaortopedicabrasileira@uol.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Suvorov Vasyl. 3/102, Bondarska st., Ukraine, Kyiv. 04073. vasil_suvorov@ukr.net