Introduction We have performed open reduction with Pemberton osteotomy, as our primary treatment method for developmental dysplasia of the hip, in more than 550 patients at our institution since 1993.
Step 1: ExposureWith the patient supine, make an anterior iliofemoral incision that is not directly on the iliac crest, dissect the subcutaneous tissue in the line of the incision, expose the iliac crest, and divide the cartilage at the iliac crest.
Step 2: Perform Iliopsoas TenotomyIdentify the rectus femoris tendon, release the iliopsoas muscle, and identify the acetabulum-hip capsule junction.
Step 3: Perform Open Reduction and OsteotomyPerform an open reduction, check hip stability, make medial and lateral cut lines, and complete the osteotomy.
Step 4: Insert Iliac Bone GraftHarvest the graft, position the reduced hip joint, insert the bone graft, repair the capsule, and close the wound.
Step 5: Postoperative Management Apply a hip spica cast after skin closure.
Results & Preop./Postop. ImagesIn our clinical and radiographic review of forty-nine patients followed for more than ten years after treatment of developmental dysplasia of the hip with a unilateral Pemberton osteotomy, there were no redislocations and no patient required additional surgery for residual hip dysplasia after the original Pemberton osteotomy.
What to Watch For Indications
Pitfalls & Challenges
We have performed open reduction with Pemberton osteotomy, as our primary treatment method for developmental dysplasia of the hip, in more than 550 patients at our institution since 1993. Originally described by Pemberton in 1965, the pericapsular pelvic osteotomy has been widely adopted for the treatment of acetabular dysplasia, hip subluxation, or frank hip dislocation in children1. Pemberton acetabuloplasty is characterized by a redirection of the acetabular roof, hinged on the triradiate cartilage after an incomplete iliac osteotomy. The shape of the acetabulum is modified …
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