PMC4511771_01
Radiography of pelvis in the anteroposterior view in the preoperative planning that highlights the developmental dysplasia of the left hip with stubborn dislocation.
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The goal was the normal biomechanics of the hip to be operated (Fig. 1).
Rigid fixation of the autograft for acetabular reconstruction with Allis plate, showing intraoperative image (A) and pelvic X-ray in post-operative anteroposterior view, showing acetabular reconstruction (B).
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Following that, the reaming of the acetabular bed was made, and the prosthetic component was applied, now under an appropriate coverage (Fig. 2).
Shortening femoral osteotomy in inverted-V showing (A) the removal of the bone fragment (B) and the 2-cm fragment (C).
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The osteotomy in V facilitates the reduction, increases the contact surface of the osteotomy and decreases the percentage of pseudoarthrosis (Fig. 3).
Intraoperative image in which femoral osteotomy in inverted-V and rigid fixation with DCP plate (A) were performed and pelvic X-ray in anteroposterior view showing the attachment after shortening and application of graft cerclage into the osteotomy (B).
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Then, definitive implant and interchangeable femoral head were applied, and the hip reduction was done (Fig. 4).
Radiographic control in the postoperative period of length discrepancy through orthoradiography of the lower limbs (A); X-ray showing autologous bone graft taken from the osteotomy fragment placed in the subtrochanteric region with cerclage by steel wire (arrow) (B).
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AP and lateral radiographs of the operated hips were also obtained, to assess the osteointegration of the graft in the acetabular bed and the consolidation of femoral osteotomy (Fig. 5).