Double innominate osteotomy

Abstract

The article describes the rationale, indications, and technique of the double innominate osteotomy for residual hip dysplasia in older children, adolescents, and adults. The procedure is considered for patients over the age of 6 years who have poor femoral head coverage, hip subluxation, or hip dislocation. Good hip motion and absence of degenerative changes are prerequisites. Two osteotomies are carried out to isolate the acetabular segment and to permit a greater amount of rotation than can be accomplished with single innominate osteotomy. Medial displacement of the hip joint, to improve the biomechanics of the hip, is accomplished by removal of a segment of pubic bone. Femoral osteotomy and soft tissue procedures are frequently carried out in conjunction with the acetabular rotation. Detailed drawings of the technique and pertinent anatomy are provided, as well as a description of potential pitfalls. Fifteen years of experience with this operation have proven it to be safe and effective in achieving the desired goals. Two clinical cases are shown to illustrate its effectiveness