We performed double innominate osteotomy in twenty-five patients with
acetabular insufficiency resulting from congenital dislocation of the hip
and other lesions. Following iliac (Salter) osteotomy, the second osteotomy
was carried out medial to the obturator foramen in the interval between the
symphysis pubis and the pubic tubercle. In children more than six years
old, adolescents, and adults, addition of the pubic osteotomy increased the
amount of acetabular rotation and coverage of the femoral head that could
be achieved. An additional benefit was that the femoral head could be
shifted medially, decreasing the length of the femoral lever arm. The
improvement in center-edge angle in the twenty-five patients averaged 27
degrees, and the acetabular index decreased an average of 19.5 degrees. The
center of the head shifted medially an average of 1.5 centimeters. Hip
stability was achieved in twenty-three of the patients.