Fixed paralytic obliquity of the pelvis occurs when the pelvis is held in an oblique position by contracture both above and below the iliac crests with an abduction contracture in one hip, an adduction contracture in the other hip, and scoliosis. The major ensuing disability is difficulty in locomotion.
We believe that the contractures below the pelvis are the main deformity and are primarily responsible for the disability. Once they are corrected, the pelvis can return to its normal position and lessening of the disability results. Any remaining scoliosis is then not dependent on the pelvic obliquity and can be dealt with separately.
Intertrochanteric osteotomy of one or both hips is the best method to achieve this correction. With one procedure it is possible to deal with flexion contracture or subluxation of the hip as well as anteversion of the femoral neck.
Thirteen patients are reported on whom this operation was performed. In all instances after operation these patients had less locomotor disability and increased functional ability to a notable and sometimes remarkable degree.