Clinical and radiological outcomes of Salter versus Pemberton osteotomies in the management of developmental dysplasia of the hip: A retrospective comparative study.

OBJECTIVE The aim of this study was to investigate whether there is a relationship between Salter and Pemberton pelvic osteotomies and avascular necrosis of femoral head in the management of developmental dysplasia of the hip (DDH). METHODS This retrospective study included 69 hips of 52 patients aged between 12-36 months, diagnosed as DDH who had undergone either Salter or Pemberton pelvic osteotomy with Smith Petersen approach. There were 35 patients in Salter Pelvic Osteotomy and 34 patients in Pemberton Pelvic Osteotomy groups. Before the treatment of DDH, Tönnis classification was used, preoperative and 24th month postoperative Acetabular Index (AI) angles were measured. Kalamchi-MacEwen grades of avascular necrosis were determined in terms of presence of avascular necrosis of the femoral head. RESULTS There were no significant differences between two osteotomy groups at the end of mid-term follow up in terms of the radiological parameters and avascular necrosis of femoral head. However it was found that the increased avascular necrosis incidence was significantly associated with Tönnis grade 4 hips. CONCLUSION Salter and Pemberton osteotomies can be both used safely in the treatment of DDH regarding their effect on the femoral head. LEVEL OF EVIDENCE Level III, Therapeutic Study.