TREATMENT

AN OBLIQUE INCLINED INNOMINATE OSTEOTOMY FOR PERTHES' DISEASE

Taek Rim Yoon, Sung Man Rowe, Sung Taek Jung, Sang Jin Park
Chonnam University Hospital, Kwangju, Korea (tryoon@chonnam.ac.kr)

Introduction: The purpose of this study was to evaluate the results of oblique inclined innominate osteotomy, which was our modification of Salter's innominate osteotomy in the direction of osteotomy and fixation method.

Materials and Methods: The operation was performed in 16 hips of 15 Perthes' disease patients: 12 boys and 3 girls. The mean age at operation was 8 years (5 to 10 years). They were followed for a mean 26 months ranging from 20 months to 43 months. Posterior half of supraacetabular ilium was cut by Gigli saw using a conventional method. The anterior half was osteotomized by reciprocal saw with a direction of 45° obliquely on the coronal plane and 30° to 40° posteroinferiorly on the sagital plan. Stable interposition of the bone block could be achieved between the osteotomy site. Clinical and radiographic results were evaluated after 24 (17-43) months.

Results: Bone union occurred in all cases within 4 months without displacement of the osteotomy. The mean center edge angle improved from a mean 19 degrees (17-22) preoperatively to 29.4 degrees (22-43). Radiolucent area indicating the site of biodegradable screw insertion and foreign body reaction around the screws appeared maximally at four to six months after surgery and then gradually disappeared.

Conclusion: The oblique inclined osteotomy provided enough stability so that one biodegradable screw could sustain the osteotomy site until bony union.