Aims: Purpose of the study was comparison of the results of different pelvic osteotomies (Chiari, Salter, triple osteotomy) in the treatment of consequences of DDH in adolescents. Methods: Analysis included 124 patients treated operatively for consequences of DDH in adolescence. The average age of patients was 13.6. All patients were divided into four groups according to the operative technique used (isolated Salter pelvic osteotomy, Salter osteotomy and corrective femoral osteotomy, Chiari pelvic osteotomy and triple pelvic osteotomy). Preoperative and postoperative values of CE angle of Wiberg, acetabulum-head ratio of Heyman-Herndon and Harris hip score were analysed. Congruency was assessed according to Stulberg classiþcation before and after operative treatment. Results: Signiþcant improvement was achieved in all groups. The greatest improvement was noticed in the group of triple pelvic osteotomies. Comparison between groups has shown that signiþcantly better results were achieved with triple pelvic osteotomy. Conclusions: In dysplastic hips without signs of damage of the femoral head and neck we suggest triple pelvic osteotomy in patients older than 10. If deformity of femoral head exists, additional radiographic examination should be made to assess the possibility of achieving spherical congruency of the hip operatively. If this can be done we suggest performing triple or Salter osteotomy with corrective osteotomy of femur. Chiari pelvic osteotomy should be reserved for patients older than 10 in whom spherical congruency can not be achieved or if degenerative changes of the hip already exist

Aims: The purpose of this study was to analyze treatment of postoperative femoral periprosthetic fractures at the Institute for orthopedic surgery ÒBanjicaÒ. Methods: There were 26 patients included in this study. Twenty-one case was of periprosthetic fracture after total hip replacement and in 5 patients there was a femoral fracture after total knee replacement. Fractures were classiþed as: type A Ð prosthesis and fracture stable; type B Ð prosthesis stable and fracture unstable; type C Ð prosthesis and fracture unstable, adequate bone stock; and type D Ð prosthesis and fracture unstable, inadequate bone stock. Functional assessment was made using the modiþed Harris score. Results: Follow up period ranged from 2 to 9 years with a mean of 3.2 years. Time spent from premier procedure till fracture averaged 2.5 years with range from 3 months to 6 years. In 14 cases treatment consisted of prostethic revision with longer cemented stem and in 10 fracture þxation was done using plate and screw and/or wire þxation. 2 patients went on for nonoperative treatment. Cortical allografts were used in 4 cases. 18 out of 26 patients returned to preinjury level of function as assessed by Harris hip score. Conclusions: Analysis conþrmed two basic principles in the treatment of periprosthetic femoral fractures: 1) Unstable and loose stems should be replaced with longer stems that would provide implant and fracture stability and 2) Displaced fractures should be stabilized.