THE CORRECTIVE EFFECT OF SALTER’S INNOMINATE OSTEOTOMY ON ACETABULAR DEFORMATION IN DEVELOPMENTAL HIP DISLOCATION

Abstract

Purpose: The major two deformations in developmental hip dislocation (DHD) is that the acetabulum is twisted and faced more anteriorly and laterally than normal. In this study, we investigated how much Salter’s Innominete Osteotomy (SIO) corrected these deformations and tried to reach the results interested with the patient selection. Materials and
Methods: In the department of Orthopaedics and Traumatology of Atatürk University Medical School, between 1998-2000 years, acetabular anteversion (AA) and acetabular index (AI) angles of 30 children with 40 DHD who underwent SIO were examined preoperatively and postoperatively. The average age was 3 years, ranging from 1.5 to 6 years. AA was measured on computed tomography scans that passed through the center of the triradiate cartilages and AI was measured on the anteroposterior pelvis radiographs.
Results: Of these cases (13 right, 7 left and 10 bilateral DHD), 26 (86.7%) were females and 4 (13.3%) males. AI ranged from 30° to 45° (average 37.4°) and AA ranged 12.8°-23.9° (average 17°) preoperatively. AI was 15°-25° (average 22°) and AA was 8.4°-17° (average 12.5°) postoperatively. Improvement in AI ranged from 5° to 27° (average 15.4°) and in AA ranged 3.1°-7° (average 4.5°).
Conclusion: In the result of this study, it was concluded that SIO was insufficent and should not be applied in the hips that AI was higher than 40°, and because of the decreasing effect of SIO on AA, acetabular anteversion-femoral anteversion angles should be measured by computed tomography preoperatively and this osteotomy should not be applied in the hips that had acetabular retroversion.