case_images: PMC7315311_01
case_images: Radiographs of the pelvis (AP in (a) and Lequesne view in (b)) showing signs of hip dysplasia.
case_images: CRIOR2020-8897066.001.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.001.jpg
case_images: fig1
case_images: MRI (coronal cut) of the right hip showing dysplasia and a hypertrophic labrum torn at its base.
case_images: CRIOR2020-8897066.002.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.002.jpg
case_images: fig2
case_images: Magnetic resonance imaging (MRI) contributed to the diagnosis of a typical hyperplasic torn labrum (Figure 2).
case_images: The pelvis with positioned osteotomes and the extruded guide (in green).
case_images: CRIOR2020-8897066.003.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.003.jpg
case_images: fig3
case_images: This selection was then separated to create a new object, which was extruded into a constant direction to produce a 10 mm thick object, named the Guide (Figure 3).
case_images: Images of the acetabular fragment in different projections (rotations).
case_images: CRIOR2020-8897066.004.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.004.jpg
case_images: fig4
case_images: This, too, was saved as a separate object (Figure 4).
case_images: Images of the acetabular fragment superimposed to the pelvis after rotation and space repositioning.
case_images: CRIOR2020-8897066.005.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.005.jpg
case_images: fig5
case_images: Then, we rotated the acetabular fragment over the center of the femoral head in order to restore normal radiographic parameters (Figure 5).
case_images: Image of the repositioned acetabular fragment, femur, and pelvis, with the ray casting technique, to simulate the transparency of the structures as in radiographs. The center edge angle (a) and Tonnis angle (b) were measured in both hips.
case_images: CRIOR2020-8897066.006.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.006.jpg
case_images: fig6
case_images: At the end, we took screenshots of the images and measured the usual radiographic parameters in order to confirm adequate correction and provided the surgeon with visual feedback during surgery (Figure 6).
case_images: Final guide printed in ABS plastic (pelvic and abdominal faces).
case_images: CRIOR2020-8897066.007.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.007.jpg
case_images: fig7
case_images: A1, GTMax, Brazil) using a pure, colorless 1.75 mm Acrylonitrile Butadiene Styrene (ABS) plastic (GTMax, Brazil) (Figure 7). After visual inspection for flaws, actual surgical chisels were tested through the slots for compatibility.
case_images: Surgical guide held in place (iliac fossa) with a reduction clamp, and a perfect fit can be noticed.
case_images: CRIOR2020-8897066.008.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.008.jpg
case_images: fig8
case_images: Perfect fit was obtained according to plan (Figure 8).
case_images: Picture of a straight osteotome inserted into the pubic slot ready to be driven through the bone. Notice the screw securing the guide to the bone.
case_images: CRIOR2020-8897066.009.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.009.jpg
case_images: fig9
case_images: Hence, a straight osteotome (measuring 2.9 x 10 x 200 mm) was introduced into the pubic slot of the guide, and after fluoroscopic confirmation of the position, was hammered into the bone creating the iliopubic bone cut (Figure 9).
case_images: Fluoroscopic images of the iliac and posterior column osteotomes being driven through the bone (a) and the extension of the posterior column cut up to the ischium cut (b).
case_images: CRIOR2020-8897066.010.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.010.jpg
case_images: fig10
case_images: The osteotome was inserted down to the incomplete ischium cut (Figure 10).
case_images: Picture of the acetabular fragment repositioned in space. Note that the planned rotation of the fragment is 5.9  in the longitudinal axis, 28  in the anterior-posterior axis, and 14  in the laterolateral axis.
case_images: CRIOR2020-8897066.011.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.011.jpg
case_images: fig11
case_images: Measurement of the center edge angle (a and b) and the Tonnis angle (c and d), for both the planned (a and c) and actual radiographs (b and d). The obtained center edge angle is equal to as planned, and the Tonnis angle is 2  less than as planned.
case_images: CRIOR2020-8897066.012.jpg
case_images: PMC7315311_01_CRIOR2020-8897066.012.jpg
case_images: fig12
case_images: Radiographs were taken and showed that the correction was as planned for both the center edge (difference = 0 ) and Tonnis angles (difference = 2 ) (Figure 12).