How Are Outcomes Affected by Combining the Pemberton and Salter Osteotomies?

Abstract

The Pembersal operation combines features of the Pemberton and Salter osteotomies. Results have usually been reported in patients with dysplasia but without frank dislocation. We asked if the following factors influence the outcome of the Pembersal operation in patients with dislocated hips: triradiate cartilage damage causing early closure; the acetabular index improvement; and the age of the patient at time of operation. We assessed triradiate cartilage damage, a modified McKay clinical classification, acetabular index, center-edge angles, Reimers index, acetabular depth-to-width ratios, Severin classification and Tönnis grading of 33 patients (44 hips) have been evaluated in this retrospective study. The mean age at surgery was 5 years (range, 1.5-14 years). The minimum followup was 5 years (mean, 10.5 years; range, 5-17 years). Preoperatively, three (7%) hips were Tönnis Grade 2, 10 (23%) were Grade 3, and 31 (70%) were Grade 4. Eight (18%) hips were Severin Class 1, 32 (73%) Class 2, and four (9%) were Class 3. According to McKay's criteria satisfactory results with a rate of 76% were obtained.

Comparıson Of The Results Of Pemberton And Salter Osteotomıes Applıed In Developmental Dysplasıa Of The Hıp

“…In various studies, the redislocation rate after PA has been reported to be low (13,19). In the current study, although the difference was not statistically significant, redislocation was determined at a lower rate in the PA group.…”

Developmental dysplasia of the hip: What has changed in the last 20 years?

“…The reported results of this operation are satisfactory; however, whether this procedure provides any advantages remains unclear [151,152] . In the older child or adolescent, if the triradiate cartilage remains open, the triple innominate osteotomy is the procedure of choice.…”

Developmental Dysplasia of the Hip

“…The key aim of pavlik harness focus on regain of normal improvement by atraumatic, repositioning and conservation of the hip joint functions. Primarily, skilful reduction of the hip depends on passive abduction and flexion [25]. In few cases which are having muscle imbalance like myelomening ocele, arthrogryposis (major stiffness), Ehlers-Danlos syndrome i.e.…”