Evaluation through: Acetabular index (AI) Center edge angle (CE) Sphericity of femoral head Avascular necrosis Severin classification
Mean pre-op. acetabular index
Mean CE angle at final follow-up
Mean Mose circle indices mm
Avascular necrosis incidence at final follow-up
Severin grade 1,2 (good)
Mean acetabular index pre-op.
Secondary Salter osteotomy Primary Salter osteotomy Mean CE angle at final outcome Mean Mose circle indices2.5mm2.4mm Avascular necrosis at final follow-up 50%31% Severin grade 1,2 (good)75%81%
Effects of primary Salter osteotomy compared to no Salter osteotmy: 1- Femoral head is better 2- Acetabulum provided better coverage 3- Avascular necrosis is less 4- higher good results according to Severin classification
Without Salter osteotomy With Salter osteotomy No. of hips3326 Mean age at 1 st op. (years) Mean radiological follow-up (years) Mean pre-op. acetabular index Subsequent surgery57.5%23% Mean CE angle at final follow-up Mean Mose circle indices3.8mm2.4mm Avascular necrosis incidence at final follow-up 57.5%31% Severin grade 1 or 2 (good)63%81%
In comparing results of primary and secondary Salter osteotomy: Better end results for primary Salter osteotomy, even though this group was more dysplastic at the start.
Dislocated hip Child older than 1.5 years Routinely including Salter osteotomy with the primary open reduction produces the best result.