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Salter's innominate osteotomy
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Salter's innominate osteotomy

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by dr. hardik pawar

by dr. hardik pawar

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  • 1. SALTER'S INNOMINATE OSTEOTOMY: Dr hardik pawar Care hospital
  • 2. AIM : • In this, the entire acetabulum together with pubis and ischium is rotated as a unit. • Redirects the acetabulum in anterolateral direction • Covers the head anteriorly and inferiorly • Hinge – pubic symphysis INDICATIONS: • CDH in children from 18 months to 6 years of age and in congenital subluxation upto early adult life. • Before the osteotomy, femoral head should be positioned opposite the level of the acetabulum achieved by period of traction. • Contractures of iliopsoas and adductor muscles must be released.
  • 3. • Mild to moderate DDH • NEAR NORMAL ROM • NO OA • CONGRUENT REDUCTION • CONCENTRIC REDUCTION • ACETABULAR INDEX < 10 -15 • CE angle < 10
  • 4. Osteotomy made from Osteotomy made from AIIS to Greater Sciatic notch reater Sciatic notch ch
  • 5. Graft is taken from iliac crest and trained to the shape of a wedge. The distal segment is shifted forward, downward and outward
  • 6. Place the graft into open segment anteriorly.
  • 7. Secure it by passing a K- wire from proximal fragment through graft into distal fragment taking care not to enter acetabulum.
  • 8. ADVANTAGES: • Relatively simple procedure. • No change in acetabular configuration. DISADVANTAGES: • Relatively unstable needs internal fixation. • Second surgery for pin removal. • Possibility of joint penetration by pins. • Limb length decrepency 1 cm • Nerve injuries – femoral , sciatic , lat cut, nerve • Loss of position • Post op hip stiffness
  • 9. • Position : supine • Approach : smith peterson • Interval : sartorious – TFL
  • 10. Salter Osteotomy
  • 11. THANK YOU