Transiliac lengthening of the lower extremity. A modified innominate osteotomy for the treatment of postural imbalance.

A modified innominate osteotomy was employed to treat postural imbalance by a hemipelvic lengthening in twenty patients, five to twenty years old. Diagnoses associated with the postural imbalance included acetabular dysplasia with ipsilateral femoral shortening, pure limb-length inequality, primary intrapelvic asymmetry, and decompensated scoliosis. The functionally low hemipelvis was lengthened as much as three centimeters by distraction at the osteotomy and insertion of a quadrangular bone graft. The option of a variable amount of acetabular redirection was especially useful in patients with ipsilateral acetabular dysplasia. Review of the patients after two to six years revealed that an average lengthening of 2.3 centimeters had been achieved. Fourteen patients had a balanced stance without a lift postoperatively, and the size of the lift required in the other six patients was greatly reduced.