Radiological and Clinical Results of Pemberton Osteotomy for Delayed Presentation of Iraqi DDH Patients

Abstract

Background: Pelvic osteotomy is a major procedure required for lately presented with developmental dysplasia of hip (DDH) patients; one of the needed osteotomies of the pelvis in such patients is Pemberton osteotomy (P.O.). Objective: To evaluate the clinical and radiological results of the P.O. for delayed presentation of Iraqi DDH patients. Methods: The study was conducted at Al-Imamein Al-Kadhimein Medical City from 2014-2020. We did the osteotomy for 32 hips of 25 patients (no one of them have neuromuscular disease). Of them 28 hips were Tönnis stage IV, 4 stage III, and 2 stage II. Results: The clinical status of all patients has improved according to modified McKay criteria, 26 of them have excellent score, 4 have good score, 2 with fair results, but no one has bad results. Radiologically, we score Severin’s classification as 62.5% with excellent, 28.1% with good, 9.4% with fair stage, and zero for bad stage. The average acetabular index corrected from 41.34⁰ into 16.17⁰. The center edge angle of wiberg reached 32.34⁰. The VCA of Lequesne became 29.66⁰. And the ACM angle became 43.33⁰. Avascular necrosis was reported as 1 hip was class I and 1 hip as class II according to Kalamchi McOwen classification. Conclusion: Although Salter R.B. when published his article about his osteotomy discussed the P.O. as one option for pelvic osteotomies meanwhile Pemberton P.A. still not publishing his article until after 4 years even it was practiced well before that time! We found that P.O. is very useful and dependable for clinical improvement and for correcting the radiological parameters to normal values yet it is simple, safe, practical, and effective osteotomy. Keywords: Pemberton osteotomy, delayed DDH, Tonnis classification, Severin’s classification, modified McKay classification, Kalamchi McOwen classification Citation: Chhaily ZA, Joda AI, Hafith AA, Abbood WH. Radiological and clinical results of Pemberton osteotomy for delayed presentation of Iraqi DDH patients. Iraqi JMS. 2021; 19(2): 182-188. doi: 10.22578/IJMS.19.2.7