Aim. The Pelvic Support Osteotomy (PSO) or Ilizarov Hip Reconstruction(IHR) is well described for the treatment of septic sequelae of infancy. The purpose of this study was to clinically, functionally and radiographically assess our short-term results of this procedure. Method. 25 patients (16 boys, 9 girls) who had undergone an IHR using the Ilizarov/TSF construct over a period of 10 years for a variety of pathologies were reviewed. Results. The mean age at surgery was 15 years 4 months. The pre-operative diagnoses were SCFE(10), hip sepsis (6), DDH (6) and Perthes (3). All had significant leg length discrepancies, 16 had a painful stiff hip, 6 had a painful mobile hip and 3 had a painless unstable hip. At surgery, a mean measured proximal valgus angle of 51? and a mean extension angle of 15? was achieved. Distal femoral lengthening averaged 4.2cm and distal varus correction was a mean of 8?. The mean fixator time was 173 days. At a mean of 2 years and 7 months follow-up the lower-extremity length discrepancy had improved from a mean of 5.6cm apparent shortening to 2.3cm. Trendelenberg sign was eliminated in 18/25 cases. Improvements in hip movements and gait parameters were observed. Stance time asymmetry, step length asymmetry, pelvic dip and trunk lurch improved significantly. One patient had conversion to a total hip replacement after 7 years, 4 patients required re-do PSO due to remodelling of the proximal osteotomies, two had heterotopic ossification and two had significant knee stiffness due to lack of compliance. Conclusion. The early results of IHR are encouraging to equalise limb lengths, negate Trendelenburg gait, provide a mobile hip with a reasonable axis and the possibility of conversion to THR in the future if needed. Potential complications need to be anticipated, the effects of remodelling and maintaining adequate knee range of motion must be emphasised

Our aim was to determine whether abnormalities noted on MRI immediately after reduction for developmental dysplasia of the hip could predict the persistance of dysplasia and aid surgical planning. Scans of 13 hips in which acetabular dysplasia had resolved by the age of four years were compared with those of five which had required pelvic osteotomy for persisting dysplasia. The scans were analysed by two consultant musculoskeletal radiologists who were blinded to the outcome in each child.

The postreduction scans highlighted a number of anatomical abnormalities secondary to developmental dysplasia of the hip, but statistical analysis showed that none were predictive of persisting acetabular dysplasia in the older child, suggesting that the factors which determine the long-term outcome were not visible on these images.