Early And Mid-Term Radiological Results of Isolated Pembersal Procedure in Cases of Developmental Dislocation of The Hip

Abstract

Aim: Early diagnosis and timely care is important in patients with Developmental Hip Dysplasia (DDH). Late presenting or neglected patients may require various osteotomy procedures. There is a limited number of articles in the literature on Pembersal osteotomy in DDH surgery. The aim of this study was to assess the outcomes of isolated Pembersal osteotomy in children over 18 months of age with DDH. Materials and Methods: A retrospective analysis was made of the outcomes of patients who underwent Pembersal osteotomy for DDH at our clinic from 2014 to 2021. The study included 9 children (7 girls, 2 boys) aged between 19 and 36 months with at least 2 years of follow-up who underwent isolated periacetabular Pembersal osteotomy with open reduction. Preoperative, early postoperative, 6 weeks postoperative and final follow-up radiographs were evaluated and Wiberg's centre-edge angle (CEA), the acetabular index (AI) and Tönnis grades were noted. Results: The mean age of the patients was 28.75 months and the follow-up period was 50.33 months. CEA and AI showed improvement in the early postoperative period and this improvement continued in the later periods. Tönnis staging showed postoperative improvement in all patients, and this improvement continued in the early postoperative period and on the 6-week follow-up radiographs. At the final follow-up examination, 3 hips had CEA <20º, AI >20º and Tönnis stage ≥2 and these 3 hips were considered as a radiologically poor outcome. Conclusion: This study demonstrated that isolated Pembersal osteotomy is an effective and safe option for the treatment of developmental dysplasia of the hip, with improvement in acetabular index and other radiological parameters. Keywords: Developmental dysplasia of the hip, periacetabular osteotomy, Pembersal osteotomy, centre-edge angle, acetabular index