Abstract
Introduction. Triple pelvic osteotomy is an effective surgical treatment for dysplastic subluxation of the hip in children aged above 12 years. However, modern studies did not assess the indicators of spine-pelvis ratios, sagittal profile of the spine in children with dysplastic subluxation of the hip following surgical treatment, and possibility of change on these values during the operation.
 Aim. This study aimed to evaluate the effectiveness of the improved technique of performing triple pelvic osteotomy on children with dysplastic subluxation of the hip.
 Materials and methods. We analyzed the x-ray images and surgical treatment of 35 female patients (44 hip joints) aged 13 to 18 years with dysplastic subluxation of the hip between 2016 and 2018. The patients were divided into two groups: the main group consisted of 20 patients (25 hip joints) who underwent surgical treatment that had taken into account the state of sagittal spine-pelvis ratios according to the improved method using personalized navigation templates, and the control group consisted of 15 patients (19 hip joints) who received surgical treatment according to the generally accepted method.
 Results. In addition to the typical clinical and radiological abnormalities of the dysplastic subluxation of the hip in 90% of patients in both groups, there were changes in the sagittal balance in the form of excessive pelvic anteversion and lumbar hyperlordosis. One year postoperatively, patients in the main group showed significant changes (p < 0.05) in the state of sagittal spine-pelvis ratios in the form of a decrease in the pelvic base angle, which led to the achievement of the average values of the angle of inclination of the sacral slope (SS) and the value of global lumbar lordosis. On the other hand, these radiological parameters in patients in the control group remained within the preoperative values.
 Conclusion. The improved technique of triple pelvic osteotomy provides conditions for the reduction of pelvic anteversion and restoration of the sagittal profile of the spine (p < 0.05). The use of personalized navigation templates allows for the most accurate multiplane correction of the acetabulum. It is necessary to include a specialized x-ray examination in the preoperative planning to assess the state of sagittal spine-pelvis ratios.
Highlights
Triple pelvic osteotomy is an effective surgical treatment for dysplastic subluxation of the hip in children aged above 12 years
Modern studies did not assess the indicators of spine-pelvis ratios, sagittal profile of the spine in children with dysplastic subluxation of the hip following surgical treatment, and possibility of change on these values during the operation
This study aimed to evaluate the effectiveness of the improved technique of performing triple pelvic osteotomy on children with dysplastic subluxation of the hip
Summary
Тройная остеотомия таза является эффективной методикой хирургического лечения детей с диспластическим подвывихом бедра старше 12 лет. Посвященные оценке показателей позвоночно-тазовых соотношений и сагиттального профиля позвоночника у детей с диспластическим подвывихом бедра после хирургического лечения, а также возможностей изменения данных величин в ходе операции. Были проанализированы результаты углубленного рентгенологического обследования и хирургического лечения 35 пациентов женского пола (44 тазобедренных сустава) в возрасте от 13 до 18 лет с диспластическим подвывихом бедра, получавших лечение с 2016 по 2018 г. Через год после хирургического лечения у пациентов основной группы произошли достоверные (p < 0,05) изменения сагиттальных позвоночно-тазовых соотношений в виде уменьшения угла наклона таза, что привело к достижению среднестатистических значений угла наклона крестца и величины поясничного лордоза. Для цитирования: Бортулёв П.И., Виссарионов С.В., Басков В.Е., и др. Влияние тройной остеотомии таза на позвоночно‐тазовые соотношения у детей с диспласти‐ ческим подвывихом бедра // Ортопедия, травматология и восстановительная хирургия детского возраста. – 2019. – Т. 7. – Вып. 2. – С. 5–16. https://doi.org/10.17816/ PTORS725-16
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