Normal female hip ap xray4/9/2024 The choice of treatment for DDH is age-dependent ( 5). As far as the acetabular side procedures are concerned, ambiguity still exists regarding the remodeling capacity of acetabulum, ideal age for pelvic osteotomy (PO), type of PO, safety and long-term radiological and clinical outcomes of each type of osteotomy. Despite extensive long-term studies, controversy still exists in all realms of surgical treatment of DDH ( 3, 4). The treatment goal is to achieve a stable, congruent and concentric hip joint as early as possible, which in turn will preclude or postpone the development of degenerative osteoarthritis (OA) of the hip ( 1, 2). Surgical correction of idiopathic developmental dysplasia of the hip (DDH) is one of the most challenging problems in pediatric orthopedic surgery. Besides, the guidelines to choose the right pelvic osteotomy are also provided. This article attempts to review the current indications for various pelvic osteotomies with a brief description of their techniques along with the outcomes and complications published thus far. Several types of re-directional and reshaping pelvic osteotomies have been described in the literature to improve the stability and restore the anatomy and biomechanics of the dysplastic hip. The choice of pelvic osteotomy depends on the age of a child, the type of dysplasia and the status of the tri-radiate cartilage. Pelvic osteotomies play a pivotal role in normalizing hip morphology. The ultimate goal of these osteotomies is to preclude or postpone the development of osteoarthritis and add more years of life to the native hip. Thus, pelvic osteotomy forms an integral part of surgical management of hip dysplasia. In an older child, the remodeling potential is limited and often the acetabular dysplasia needs surgical intervention in the form of a pelvic osteotomy. In a younger child, positioning the femoral head into the acetabulum helps in reciprocal remodeling of the acetabulum and correction of dysplasia. Acetabular dysplasia is a significant problem in the spectrum of developmental dysplasia of hip.
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