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. 2011 Aug;35(8):1203-8.
doi: 10.1007/s00264-010-1126-1. Epub 2010 Sep 28.

Chiari pelvic osteotomy in the treatment of adolescent hip disorders: possibilities, limitations and complications

Zoran Vukasinovic  1 , Dusko Spasovski, Nemanja Slavkovic, Zoran Bascarevic, Zorica Zivkovic, Branislav Starcevic
Affiliations

Chiari pelvic osteotomy in the treatment of adolescent hip disorders: possibilities, limitations and complications

Zoran Vukasinovic et al. Int Orthop. 2011 Aug.

Abstract

Ninety-nine hips treated by the Chiari pelvic osteotomy were included in this study designed as a retrospective review. The group consisted of 36 male and 50 female patients, with mean age of 15.6 years. Each was diagnosed with developmental dysplasia of the hip (DDH) or avascular necrosis of the femoral head--Legg-Calve-Perthes disease (LCP)--and postreduction avascular necrosis (PAN). Five hip parameters (the acetabular angle of Sharp, the center-edge (CE) angle of Wiberg, the percentage of femoral head uncoverage, the acetabular depth ratio, and the Shenton-Menard arch continuity) were evaluated. Functional outcome was assessed according to Harris hip score (HHS) and McKay criteria for clinical evaluation. The postoperative results showed improvement in all the radiographic parameters. The angle of Sharp showed a decrease of 8.62º (p < 0.01). The CE angle of Wiberg showed an increase of 28.76º (p < 0.01), and the uncoverage of the femoral head showed a decrease of 51.51% (p < 0.01). The improvement of HHS was 11.93 (p < 0.05). The patients' satisfaction was indicated by grade 4.1 ± 0.94 and the doctor's satisfaction by grade 3.7 ± 1.16. The Chiari pelvic osteotomy, in spite of the development of biologically better procedures, has retained its position in the treatment of adolescent hip disorders.

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Figures

Fig. 1
Fig. 1
a Postreduction avascular necrosis of the left hip in a 14-year-old female, previously surgically treated; preoperative anteroposterior (AP) view. b The same patient four years postoperatively (Chiari pelvic osteotomy done); AP view
Fig. 2
Fig. 2
a Postreduction avascular necrosis of both hips in a 12-year-old female; preoperative anteroposterior (AP) view. b The same patient five years postoperatively (Chiari pelvic osteotomy and great trochanter translocation done bilaterally); AP view
Fig. 3
Fig. 3
a Postreduction avascular necrosis of both hips in a 16-year-old male; preoperative anteroposterior (AP) view. b The same patient five years postoperatively (Chiari pelvic osteotomy done bilaterally), bilateral osteotomy nonhealing with break of osteofixation material. Left, healing occurring later. The patient was without any complaints and with full hip motion; AP view
See this image and copyright information in PMC

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