Wednesday 16 September 2009

IS THERE A ROLE FOR PELVIC SUPPORTING OSTEOTOMY







Pelvic supportive osteotomy both Shanz and Milch bachelor's osteotomy were the mainstay to avoid a trendelenberg gait in the past for paralytic dislocated hips. I understand this is still discussed in the exams and am unsure of its use even in the financially challenged.






Of late we had to convert a spate of these ostetomies to thr. Below is an example. 40 yr old male who had a shanz osteotomy 20 yrs ago, now has pian in hs Lt. hip. Neurologically normal.



1.Was a Shanz indicated?



2. Would a Chiari osteotomy been better at that time?



What now?
We did a perpendicular oseotomy at the level where the 8 mm drill from the ideal proximal entry point exited on the lateral cortex, drill the distal fragment, then sleeve and finally used a unicortical plate for additional stabilisation of the osteotomy(not always need).

No comments:

Post a Comment