FIXED PELVIC OBLIQUITY AFTER POLIOMYELITIS - CLASSIFICATION AND MANAGEMENT

We classified fixed pelvic obliquity in patients after poliomyelitis i nto two major types according to the level of the pelvis relative to t he short leg. Each type was then divided into four subtypes according to the direction and severity of the scoliosis. In 46 patients with ty pe-I deformity the pelvis was lower and in nine with type II it was hi gher on the short-leg side, Subtype-A deformity was a straight spine w ith a compensatory angulation at the lower lumbar level, mainly at L4- L5, subtype B was a mild scoliosis with the convexity to the short-leg side, subtype C was a mild scoliosis with the convexity opposite the short-leg side, and subtype D was a moderate to severe paralytic scoli osis with the convexity to the short-leg side in type I and to the opp osite side in type TI. A combination of surgical procedures improved t he obliquity in most patients, These included lumbodorsal fasciotomy, abductor fasciotomy and stabilisation of the hip by triple innominate osteotomy with or without transiliac lengthening, In patients with typ e ID or type IID appropriate spinal fusion was usually necessary.