PEMBERTON PELVIC OSTEOTOMY AND VARUS ROTATIONAL OSTEOTOMY IN THE TREATMENT OF ACETABULAR DYSPLASIA IN PATIENTS WHO HAVE STATIC ENCEPHALOPATHY

Forty-four patients (fifty-two hips) who had static encephalopathy and acetabular dysplasia were managed with a Pemberton osteotomy as part of a comprehensive operative approach. Thirty-three patients had quadr iplegia and were unable to walk; the remaining eleven patients had dip legia and could walk. The age at the time of the operation ranged from four years and five months to sixteen years and five months, as an op en triradiate cartilage is a prerequisite for the Pemberton procedure. Concomitant operative procedures included a varus rotational osteotom y in fifty of the involved hips, a soft-tissue release in thirty-seven hips, and an open reduction in thirteen hips. The mean center-edge an gle preoperatively was -11 degrees (range, -80 to 17 degrees), which i mproved to a mean of 27 degrees (range, 5 to 62 degrees) at the time o f the latest follow-up. The mean duration of follow-up was four years (range, two years to eight years and eight months). At the time of wri ting, none of the hips had redislocated but one hip had subluxated. Ei ght of the hips had been painful preoperatively, but none of these was painful at the time of the most recent follow-up. One patient who had not had pain in the hip preoperatively had pain at the time of the fo llow-up evaluation. There were no complications attributable to poster ior uncovering of the hip. The age of the patient at the time of the o peration had no discernible effect on the result.