[Is sufficient femoral head coverage obtained after Pemberton's pericapsular osteotomy? Evaluation by three-dimensional computed tomographic reconstruction].

Abstract

We evaluated femoral head coverage by three-dimensional computed tomographic reconstruction after Pemberton's pericapsular osteotomy with open reduction in cases with developmental dysplasia of the hip. In a prospective design, routine radiographs of 15 consecutive patients were obtained and three-dimensional computed tomographic reconstruction was performed preoperatively and six months after surgery. The mean age at the time of surgery was 26 months (range 18 to 34 months). Twelve patients were girls and three were boys. The mean acetabular index was 38 degrees (range 33 degrees -52 degrees ) preoperatively, and 19 degrees (range 16 degrees -23 degrees ) postoperatively. Comparison between pre- and postoperative three-dimensional computed tomographic reconstruction images revealed increased acetabular adduction and extension, and decreased acetabular anteversion in all cases. Sufficient coverage of the femoral head was documented in all patients. Pemberton's pericapsular osteotomy provides successful results in appropriate cases, with sufficient coverage of the femoral head. However, if there is any doubt, utilization of three-dimensional computed tomographic reconstruction images may contribute to a more precise evaluation of the outcome.