The pelvic support osteotomy is a double level osteotomy of the femur with the aim to stabilize the pelvis. Pelvic support osteotomy can successfully correct a Trendelenburg gait and simultaneously restore knee alignment and correct lower-extremity length discrepancy. Using the special angulated plate for proximal valgus extension osteotomy and the distal lengthening osteotomy monolateral external fixator is a good alternative to increase the patient comfort.
Dear Cen
Could you explain the actual status of the lower limb of patient?
A 11-year-old, white girl, was treated operatively by pelvic support osteotomy. We have done two operations. The first operation consist in lengthening of the left femur for 6cm with monolateral lengthening external fixatator. The second operation consist in pelvic support osteotomy of the left femur and lengthening for 4 cm. The limb was well aligned after healing, with the axis aligned under the medial wall of the acetabulum.
We present a technique of the Ilizarov pelvic support osteotomy using internal system for proximal valgus osteotomy and monolateral external fixation technique for distal femoral osteotomy and elongation. The limb was well aligned after healing, with the axis aligned under the medial wall of the acetabulum. Her postoperative range of motion was: flexion 80 degrees, abduction 20 degrees, adduction 15 degrees, internal rotation 20 degrees, and external rotation 25 degrees. Her leg lengths were brought within an acceptable range, and she had a negative Trendelenburg-Duchenne test at follow-up. At the time of follow-up, five years, the mean lower-extremity length discrepancy had improved from 10 cm preoperatively to 0.5 cm. postoperatively.
A 11-year-old girl who had suffered septic arthritis of the left hip at the neonatal period and presented now with a painless limp, pelvic instability, Trendelenburg sign positive and leg length discrepancy with 10 cm of shortening of left femur. The hip was classified as Type IVA, with severe limb-length discrepancy, acetabular dysplasia, premature closure of the triradiate cartilage, and marked proximal migration of the femur. Therefore, an pelvic support osteotomy was planned as only reasonable treatment option for improving the gait, equalization the length limb and functional stabilsation of the left leg.
Dear Cean
This article may be useful for you
The pelvic support osteotomy: indications and preoperative planning
Dimitrios Pafilas and Selvadurai Nayagam
Strategies Trauma Limb Reconstr. Sep 2008; 3(2): 83–92.
Published online Aug 30, 2008.
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