Comparison of the Outcomes of Salter and Pemberton Osteotomies in the Treatment of Developmental Hip Dysplasia

Aim

The aim of this study is to compare two common procedures, Salter and Pemberton osteotomies, applied in developmental hip dysplasia (DDH) treatment.

Materials and Methods

The patients, treated with Salter and Pemberton osteotomies in our clinic due to DDH and applied for the last follow-up upon call, were included in this study. Preoperative acetabular index (AI) as well as AI, center-edge angle, and femoral head avascular necrosis type regarding Bucholz-Ogden classification in the radiographs, obtained at the last follow-up, were assessed. Clinical outcomes were evaluated considering modified McKay criteria.

Results

Ten and 35 hips of 36 patients, included in this study, were treated with Pemberton and Salter osteotomies, respectively. Salter group comprised 7 (20.0%) excellent, 20 (57.1%) good, 5 (14.3%) fair, and 3 (8.6%) poor results whereas Pemberton group comprised 7 (70.0%) excellent, 1 (10.0%) good, 1 (10.0%) fair, and 1 (10.0%) poor results, according to modified McKay criteria. AI improvement demonstrated insignificant difference between Salter (26.71±6.1 degrees) and Pemberton (27.8±6.26 degrees) groups (p=0.87). Salter (26.76±13.35 degrees) and Pemberton (24.5±13.96 degrees) groups demonstrated no significant difference considering the center-edge angle (p=0.728). The osteotomy groups also demonstrated insignificant difference regarding the presence (p=0.546) and distribution of the types of avascular necrosis (p=0.516).

Conclusion

Salter and Pemberton osteotomies are efficient procedures in DDH treatment over 18 months of age. One of them can be applied in patients between the ages of 18 months and 6 years, depending on the surgeon’s experience and preference in case no contraindication is present.

Keywords: Developmental dysplasia of hip; developmental hip dislocation; osteotomy; femoral head necrosis; child health