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

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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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Authors and Affiliations

  1. Institute for Orthopaedic Surgery “Banjica”, University of Belgrade, Medical Faculty, Belgrade, Serbia

    Zoran Vukasinovic, Nemanja Slavkovic & Zoran Bascarevic

  2. Institute for Orthopaedic Surgery “Banjica”, Belgrade, Serbia

    Dusko Spasovski

  3. Medical Center “Dr Dragisa Misovic”, European University, US Medical School, Belgrade, Serbia

    Zorica Zivkovic

  4. Clinical Center of Serbia, Institute of Orthopedic Surgery and Traumatology, University of Belgrade, Medical Faculty, Belgrade, Serbia

    Branislav Starcevic

Authors
  1. Zoran Vukasinovic
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  2. Dusko Spasovski
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  3. Nemanja Slavkovic
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  4. Zoran Bascarevic
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  5. Zorica Zivkovic
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  6. Branislav Starcevic
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Correspondence to Zoran Vukasinovic.

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Vukasinovic, Z., Spasovski, D., Slavkovic, N. et al. Chiari pelvic osteotomy in the treatment of adolescent hip disorders: possibilities, limitations and complications. International Orthopaedics (SICOT) 35, 1203–1208 (2011). https://doi.org/10.1007/s00264-010-1126-1

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  • DOI: https://doi.org/10.1007/s00264-010-1126-1

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