by dr. hardik pawar

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