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PEMBERTON PERICAPSULAR OSTEOTOMY THE EFFECT OF FEMORAL SHORTENING



Abstract

Purpose: To compare the radiological and functional results of Developmental Dysplasia of the Hip (DDH) patients who received Pemberton Pericapsular Osteotomy (PPO) with femoral shortening (FS) and those who did not.

Material and Method: Between the years 2001–2006 of 12 DDH patients 14 hips (7 female unilateral, 2 female bilateral, 3 male) received treatment. 5 patients (6 hips) received PPO and/or open reduction (OR) (group 1), and 7 patients (8 hips) received OR+PPO+FS (group 2). The average age of group 1 was 2.06, and group 2 was 5.08 years. All patients received one stage surgery. According to the Tönnis the grade of displacement and the acetabular index (AI) was determined preop and postop. Clinical evaluations were made with McKay, radiological with Severin and femoral head avascular necrosis measurements were taken with Kalamchi-MacEwen. The average follow up period was 5.8 ±1.6 for group 1 and 6.67 ±1.4 years for group 2.

Results: AI for group 1 was 40.12°±4.09 preop and 16.88°±6.45 (p=0.012) postop, group 2 was 44.33°±7.31 preop, and 30°±5.66 (p=0.009) postop. Both groups showed a significant correction (p< 0.05). According to Severin classification group 1 was 87.5% Ia, 12.5% III, group 2 was 75% Ia, 12.5% Ib, 12.5% II. According to Kalamchi-McEven measurements group 1 was 75% Type I, 25% Type II. Functional results of group 1 were 87% I (very good), 12.5% II (good), group 2 100% I (very good). For each group no significant difference was found in terms of clinical and radiological results (p> 0.05).

Conclusion: Functional and radiological mid term results of DDH patients who received PPO with or without FS could be classified as very good.

Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Tel: +41 44 448 44 00; Email: office@efort.org

Author: Mehmet Balioglu, Turkey

E-mail: mehmetbalioglu2003@yahoo.com