Background: In 1969 Dega described a transiliac
osteotomy to treat residual acetabular dysplasia secondary to congenital
hip dysplasia or dislocation. We were unable to find a thorough
description of the technique in the English-language orthopaedic
literature, and the number of clinical follow-up series is small.
Methods: Twenty-two children (twenty-four hips)
with an average age of five years and ten months and varying degrees
of congenital hip dysplasia, subluxation, or dislocation were treated
with a Dega osteotomy. Twenty hips (83%) had a concomitant femoral
osteotomy and thirteen (54%) had an anterior open reduction
of the hip in addition to the Dega osteotomy. To be included in
the study group, each patient had to have complete clinical documentation
of the range of motion, presence or absence of a limp, limb-length
discrepancy, hip pain, and limitation of activity. Radiographs were reviewed
to determine the acetabular index, the center-edge angle, whether
the Shenton line was intact or broken, and any change in the projection of
the obturator foramen.
Results: At an average of fifty-five months postoperatively, all
patients demonstrated unlimited physical activity and no limp. The
average acetabular index changed from 33° preoperatively to 12°
at the time of follow-up. The center-edge angle ranged from less
than —30° to 18° preoperatively and from 18° to 40° (average,
31°) at the time of follow-up. A change in the obturator foramen
was observed in fourteen hips (58%). The Shenton line was
broken in seventeen hips preoperatively but in none postoperatively.
One Dega osteotomy was revised immediately after the index operation,
and three hips underwent late repeat correction of the proximal
part of the femur; one of the repeat corrections was performed together
with a repeat Dega osteotomy.
Conclusions: Our initial experience with the Dega
osteotomy demonstrated it to be a valuable surgical treatment of
congenital dysplasia of the hip in a child of walking age. Our experience
is comparable with that of many European authors, including those
reporting studies from Dega’s own institution.