New technique to overcome surgical pitfall during Chiari osteotomy

ABSTRACT

Chiari pelvic osteotomy is a salvage procedure, which aims mainly to achieve lateral coverage of femoral head in adolescents with acetabular dysplasia. The level of pelvic osteotomy is very important and crucial. It should be less than five mm from the joint space and directed with a cephalic inclination of 10° toward the sacroiliac joint. High-level osteotomy will create an undesired step between the femoral head and the new acetabulum. A new technique is described here to overcome an undesired step that was created by high level osteotomy in a 14 year old girl with residual acetabular dysplasia after surgically treated developmental dysplasia of the hip. The technique included distal transfer of the lateral part of the iliac bone without the need to dismantle the Chiari osteotomy and resulted in good outcome: