Extraarticular fractures of the pelvic ring after periacetabular osteotomy could impair stability of the acetabular fragment
and cause poor clinical and radiographic outcomes. We evaluated 17 patients (17 hips) with fractures of either the ipsilateral
os pubis (n = 12) or os ischium (n = 5) during the postoperative period after periacetabular osteotomy. Ischial fractures
seemed more debilitating with two of five resulting in painful nonunions for which additional surgery was performed. In contrast,
only one patient with pubic fracture had additional surgery. Ischial fractures took almost twice as long to achieve resolution
of symptoms compared with pubic fractures, and when left untreated, asymptomatic nonunions developed in three of five. However,
we observed no effect on acetabular fragment positioning or long-term clinical outcome. It is essential to be aware of this
potential complication and realize it could be accompanied by substantial morbidity for patients during the rehabilitation
period after periacetabular osteotomy, but does not seem to influence the longer-term outcome.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Study conducted at the Department of Orthopaedic Surgery, Children’s Hospital, Boston, MA.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent was obtained.