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.

Introduction: Prior to skeletal maturity temporary hemiepiphyseal stapling is a treatment method for angular deformities of long bones. The purpose of this study is to investigate the effects of temporary hemiepiphyseal stapling on the bone geometry and histology of physis.

Materials & Methods: Proximal medial epipyseal stapling of the right tibia were done in 46 New Zealand rabbits. 23 of them were euthanized at the end of 3 weeks. For the remaining 23 rabbits staples were fixed subperiostally (group A) in 11, and extraperiosteally (group B) in 12 rabbits. After 3 weeks the staples removed and the rabbits were euthanized at the end of 6 weeks. Bromodeoxyuridine used to evaluate cellular activity of the growth plate. Radiographs utilized for bone alignment.

Results: The articular surface-diaphysis angle was significantly increased at the end three weeks when compared to controls (27.7° vs. −1.5°, p:0.001). Cellular activity was decreased but preserved in the stapled tibias. At the end of six weeks while the angular deformity was worsening in group A 22.9° vs. 35.6°, p:0.001) it was improving in group B (23.2 ° vs. 14.6°, p:0.001). Bone tissue bridging the growth plate was noted in group A. Cellular activity in the group B was higher than group A at the end of six weeks.

Conclusion: Hemiepiphyseal stapling causes decreased cellular activity at the growth plate, which leads to angulation. With removal of staples, increased cellular activity at the growth plate results in the improvement of the deformity if staples were inserted extraperiosteally. Temporary extraperiosteal hemiepiphyseal stapling could be used as a safe and effective method for treatment of angular deformities prior to skeletal maturity.