Abstract

A new form of triple-osteotomy of the pelvis is described. The ischium is osteotomized from a dorsal approach, immediately behind the hip joint. The ischium is left in place, the ligaments giving stability to the sacrum remain in tension. After turning the patient a small medial incision is done for the osteotomy of the pubis. The The ilium is cut through with a Gigli saw from a small incision laterally. It should descend medially in a distance of 2-2,5 cm apart from the joint. The possibilities to turn the acetabulum are very good and correspond to the amount of abduction before operation. Injuries to the sciatic nerve are avoided by the dorsal approach. The evaluations of 32 patients with different degrees of dislocations are reported. The osteotomy may be done even in flat-shaped femoral heads, where the acetabulum is still congruent as long as it is possible to abduct the leg and turn the femoral head into the acetabulum. It has been done in high dislocations with secondary acetabulae as well. The operation may be used in children above 8 years, where the osteotomy of Salter and acetabuloplasties are not efficient any more. In contrary to Chiari's osteotomy the acetabulum is covered by cartilage and the angle of inclination usually normal. It can be used in adults and beginning arthrosis as long as the abduction is not limited.