Ganz (or Bernese) osteotomy for hip dysplasia

Case contributed by Dr Tim Luijkx

Presentation

Congenital hip dysplasia on the right side.

Patient Data

Age: 19
Gender: Female
X-ray

Preoperative images

Poor coverage of the right femoral head by acetabulum, which has a steep angle. Abnormal shape of femoral head. No significant dislocation of femoral head. Normal left hip.

Findings consistent with hip dysplasia on the right side..

X-ray

First postoperative images

First postoperative imaging. Osteomy of superior ramus of pubic bone and bone surrounding the acetabulum. Also, a bone graft was harvested from the iliac wing.

The resulting free-floating acetabulum is subsequently angulated to result in better coverage of the femoral head. Fixation with a screw of the acetabulum through the iliac wing and the interposed iliac bone graft.

X-ray

Follow-up radiographs two years later

Consolidation of medial attachments of the acetabulum with the pubic bone. Irregular border of osteotomy edge superiorly, no signs of consolidation.

CT

CT for closer inspection of consolidation

CT-images confirm the lack of consolidation on the superior edges of the acetabular complex.

Case Discussion

Ganz osteotomy, also known also Bernese osteotomy, can be performed to artificially enlarge the coverage of the femoral head by the acetabulum. It can alleviate pain and potentially slows down the development of coxarthritis later in life 1.

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Case information

rID: 39408
Case created: 3rd Sep 2015
Last edited: 14th Aug 2016
Inclusion in quiz mode: Excluded

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