| Osteotomies around
the Hip |
| |
| Points to Ponder |
| |
 |
Residual Dysplasia
is Most Common Cause for Early Adult Osteoarthritis... |
| |
|
|
Normalization
of Hip Radiograph |
 |
|
| |
Best Chance for Normal
Mechanics |
| |
Best Chance for Normal
Function |
| |
|
|
Purpose of
Hip Osteotomies |
|
|
| |
Normalize Hip Anatomy |
| |
Normalize Hip Mechanics
(forces across joints) |
| |
Prevent Premature
Arthritis |
|
| |
|
| Classification |
|
| |
|
| |
|
| Type 1 : Complete or
Redirectional Osteomies |
| |
| Problem
: Inclination |
|
Solution
: Change in Orientation |
| |
|
 |
 |
|
Examples
Single inniminate: Salter
Double innominate: Sutherland
Triple innominate: Tonnis, Ganz |
| |
|
| top |
|
| Type 2 : Incomplete/
Change in Slope |
| |
| Problem
: Slope |
|
Solution
: Change in Slope |
| |
|
 |
 |
|
Examples:
Pemberton
Albee
Dega |
| |
|
| top |
|
| Type 3 : Salvage Procedures |
| |
| Problem:
Capacity |
|
Solution:
Change in Volume |
| |
|
 |
 |
|
Examples:
Chiari
Shelf |
| |
|
| top |
| Notes : |
| Salter's Osteotomy |
| Indications |
|
Primary Open
Reduction |
|
|
|
Residual dysplasia |
|
|
|
Age 2-8 years |
|
|
|
Provides 15 lat
25 Ant coverage |
|
| |
 |
| |
|
| top |
| Chiari’s Osteotomy |
| Indications |
|
Damaged Incongruous
hip |
|
|
|
(DDH, Septic, Perthes) |
|
|
|
9 years-Adult |
|
| |
|
| |
|
| top |
| Shelf Procedure |
| Indications |
|
Damaged Incongruous
hip |
|
|
|
(DDH, Septic, Perthes) |
|
|
|
Age group: 10 years-Adult |
|
| |
 |
|
| Multiple
drill holes made along acetabular roof |
| |
| Drill
holes connected with a nibbler to form
a slot |
|
|
| |
 |
|
| Placement
of grafts |
| |
| Suturing
of rectus tendon |
|
|
| |
|
| top |
