Iliac crest bone-muscle transfer in periacetabular osteotomy

Ganz et al(1) reported acetabular osteotomy for extensive acetabular reorie ntation without changing the acetabular diameter. This article reports our modification of this surgical technique, which preserves the integrity of t he tensor fascia latea muscle as well as providing viable bone for bone gra ft at the anterior iliac osteotomy site. The interval between the sartorius and tensor fascia lata is developed distal to the anterosuperior iliac spi ne. After iliac osteotomy through the anterosuperior iliac spine, the dista l portion of the anterosuperior iliac spine (acetabular segment), along wit h its slip of tensor fascia lata (1-2 cm), is separated and shaped to fit t he anterior bone gap. Two small holes are drilled into that segment and als o into the distal cut surface in the anterior portion of the remaining cres t so that when the sutures are tightened, the tensor muscle is preserved an atomically and bone grafting is achieved.