Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of femoral head coverage following Chiari pelvic osteotomy in adolescents by three-dimensional computed tomography and conventional radiography

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Currently, the cover of the femoral head was mainly assessed using conventional plain films after Chiari pelvic osteotomy in most studies. The purpose of the current study was to observe whether the femoral head coverage measured by three-dimensional computed tomography (3D-CT) was consistent with the radiographic findings.

Patients and methods

A total of 24 patients (24 hips) with an average age of 11.5 years, underwent Chiari osteotomy due to acetabular dysplasia, and 15 subjects (30 hips) of normal control with a mean age of 12 years were involved in the study. The pre- and postoperative coverage of femoral head was measured by using conventional plain film and 3D-CT on the anterior 1/4, middle 1/2, and posterior 1/4 coronal plane. The anterolateral, mediolateral and posterolateral coverage measured by 3D-CT were compared with the coverage measured by plain radiograph, and which were also compared with the normal control individuals.

Results

The postoperative anterolateral, mediolateral coverage measured by 3D-CT was significantly smaller than that measured by radiography (P < 0.01). No significant difference was found between the 3D-CT measurements on the posterolateral coverage and the radiographic results. The anterolateral femoral head coverage in the patients following Chiari pelvic osteotomy was also smaller than that in the normal control individuals (P = 0.026). In contrast, the postoperative posterolateral coverage in the patients was more excessive than that in the normal control individuals (P = 0.001).

Conclusion

Conventional radiographs may show sufficient cover of the femoral head after Chiari osteotomy, whereas in fact, the cover may be not perfect, especially on the anterolateral part. Therefore, the postoperative 3D-CT is beneficial for evaluating the outcome of Chiari osteotomy, especially when the anterolateral coverage of femoral head is significantly insufficient preoperatively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Chiari K (1974) Medial displacement osteotomy of the pelvis. Clin Orthop Relat Res 98:55–71

    Article  PubMed  Google Scholar 

  2. Calvert PT, August AC, Albert JS, Kemp HB, Catterall A (1987) The Chiari pelvic osteotomy. A review of the long-term results. J Bone Joint Surg Br 69:551–555

    PubMed  CAS  Google Scholar 

  3. Høgh J, Macnicol MF (1987) The Chiari pelvic osteotomy. A long-term review of clinical and radiographic results. J Bone Joint Surg Br 69:365–373

    PubMed  Google Scholar 

  4. Lack W, Windhager R, Kutschera HP, Engel A (1991) Chiari pelvic osteotomy for osteoarthritis secondary to hip dysplasia. Indications and long-term results. J Bone Joint Surg Br 73:229–234

    PubMed  CAS  Google Scholar 

  5. Matsuno T, Ichioka Y, Kaneda K (1992) Modified Chiari pelvic osteotomy: a long term follow-up study. J Bone Joint Surg Am 74:470–478

    PubMed  CAS  Google Scholar 

  6. Ohashi H, Hirohashi K, Yamano Y (2000) Factors influencing the outcome of Chiari pelvic osteotomy: a long-term follow-up. J Bone Joint Surg Br 82:517–525

    Article  PubMed  CAS  Google Scholar 

  7. Reynolds DA (1986) Chiari innominate osteotomy in adults. Technique, indications and contra-indications. J Bone Joint Surg Br 68:45–54

    PubMed  CAS  Google Scholar 

  8. Windhager R, Pongracz N, Schonecker W, Kotz R (1991) Chiari osteotomy for congenital dislocation and subluxation of the hip. Results after 20 to 34 years follow-up. J Bone Joint Surg Br 73:890–895

    PubMed  CAS  Google Scholar 

  9. Reddy RR, Morin C (2005) Chiari osteotomy in Legg–Calve–Perthes disease. J Pediatr Orthop B 14:1–9

    Article  PubMed  Google Scholar 

  10. Rejholec M, Stryhal F, Rybka V, Popelka S (1990) Chiari osteotomy of the pelvis: a long-term study. J Pediatr Orthop 10:21–27

    PubMed  CAS  Google Scholar 

  11. Macnicol MF, Lo HK, Yong KF (2004) Pelvic remodelling after the Chiari osteotomy: a long-term review. J Bone Joint Surg Br 86:648–654

    Article  PubMed  CAS  Google Scholar 

  12. Kotz R, Chiari C, Hofstaetter JG, Lunzer A, Peloschek P (2009) Long-term experience with Chiari’s osteotomy. Clin Orthop Relat Res 467:2215–2220

    Article  PubMed  Google Scholar 

  13. Ito H, Tanino H, Yamanaka Y, Nakamura T, Minami A, Matsuno T (2011) The Chiari pelvic osteotomy for patients with dysplastic hips and poor joint congruency. J Bone Joint Surg Br 93:726–731

    Article  PubMed  CAS  Google Scholar 

  14. Van der Bom MJ, Groote ME, Vincken KL, Beek FJ, Bartels LW (2011) Pelvic rotation and tilt can cause misinterpretation of the acetabular index measured on radiographs. Clin Orthop Relat Res 469:1743–1749

    Article  PubMed  Google Scholar 

  15. Roach JW, Hobatho MC, Baker KJ, Ashman RB (1997) Three-dimensional computer analysis of complex acetabular insufficiency. J Pediatr Orthop 17:158–164

    PubMed  CAS  Google Scholar 

  16. Li LY, Zhang LJ, Zhao Q, Wang EB (2009) Measurement of acetabular anteversion in developmental dysplasia of the hip in children by two- and three-dimensional computed tomography. J Int Med Res 37:567–575

    PubMed  CAS  Google Scholar 

  17. Jia J, Zhang L, Zhao Q, Li L, Liu X (2011) Does medial rotational deformity of the whole pelvis universally exist in unilateral DDH? Arch Orthop Trauma Surg 131:1383–1388

    Article  PubMed  Google Scholar 

  18. Jia J, Li L, Zhang L, Zhao Q, Liu X (2012) Three dimensional-CT evaluation of femoral neck anteversion, acetabular anteversion and combined anteversion in unilateral DDH in an early walking age group. Int Orthop 36:119–124

    Article  PubMed  Google Scholar 

  19. Colton CL (1972) Chiari osteotomy for acetabular dysplasia in young subjects. J Bone Joint Surg Br 54:578–589

    PubMed  CAS  Google Scholar 

  20. Heyman CH, Herndon CH (1950) Legg–Perthes disease. A method for the measurement of the roentgenographic result. J Bone Joint Surg Am 32:767–778

    PubMed  CAS  Google Scholar 

  21. Bowman KF Jr, Fox J, Sekiya JK (2010) A clinically relevant review of hip biomechanics. Arthroscopy 26:1118–1129

    Article  PubMed  Google Scholar 

  22. Benson MK, Evans DC (1976) The pelvic osteotomy of Chiari: an anatomical study of the hazards and misleading radiographic appearances. J Bone Joint Surg Br 58:164–168

    PubMed  CAS  Google Scholar 

  23. Karami M, Fitoussi F, Ilharreborde B, Pennecot GF, Mazda K, Bensahel H (2008) The results of Chiari pelvic osteotomy in adolescents with a brief literature review. J Child Orthop 2:63–68

    Article  PubMed  Google Scholar 

  24. Nakata K, Masuhara K, Sugano N, Sakai T, Haraguchi K, Ohzono K (2001) Dome (modified Chiari) pelvic osteotomy: 10- to 18-year followup study. Clin Orthop Relat Res 389:102–112

    Article  PubMed  Google Scholar 

  25. Anwar MM, Sugano N, Matsui M, Takaoka K, Ono K (1993) Dome osteotomy of the pelvis for osteoarthritis secondary to hip dysplasia. An over five-year follow-up study. J Bone Joint Surg Br 75:222–227

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declared that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Paediatric Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China

    LianYong Li, JingYu Jia, Qun Zhao, LiJun Zhang, ShiJun Ji & EnBo Wang

Authors
  1. LianYong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. JingYu Jia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qun Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. LiJun Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. ShiJun Ji
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. EnBo Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to LiJun Zhang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, L., Jia, J., Zhao, Q. et al. Evaluation of femoral head coverage following Chiari pelvic osteotomy in adolescents by three-dimensional computed tomography and conventional radiography. Arch Orthop Trauma Surg 132, 599–605 (2012). https://doi.org/10.1007/s00402-012-1464-0

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-012-1464-0

Keywords

Search

Navigation