Paediatric: Salter innominate osteotomy: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Paediatric: Salter innominate osteotomy

Sample item

A 3-year-old with untreated developmental dysplasia of the hip has a well-formed femoral head and a shallow acetabulum with an open triradiate cartilage. Which procedure redirects the acetabulum to give more anterolateral cover?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Salter innominate osteotomy

The Salter innominate osteotomy cuts the ilium above the acetabulum and rotates the acetabulum as one piece through the symphysis pubis, increasing anterior and lateral cover. It needs a concentric reduction and a flexible symphysis, so it is used in children aged about 18 months to 6 years. Pemberton osteotomy is a related incomplete osteotomy that reshapes the acetabular roof.

Option by option

  • A. Girdlestone excision

    Girdlestone excision is a salvage procedure for infection or failure.

  • B. Hip arthrodesis

    Arthrodesis would sacrifice joint movement unnecessarily.

  • C. Salter innominate osteotomy (correct)

    Correct. Salter's osteotomy redirects the acetabulum to cover the head.

  • D. Total hip replacement

    Total hip replacement is inappropriate in a young child.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Salter innominate osteotomy. The Salter innominate osteotomy cuts the ilium above the acetabulum and rotates the acetabulum as one piece through the symphysis pubis, increasing anterior and lateral cover.

Why is "Girdlestone excision" not the answer?

Girdlestone excision is a salvage procedure for infection or failure.

Why is "Hip arthrodesis" not the answer?

Arthrodesis would sacrifice joint movement unnecessarily.

Why is "Total hip replacement" not the answer?

Total hip replacement is inappropriate in a young child.

What concept does this question test?

It tests Paediatric: Salter innominate osteotomy in Orthopaedics. It needs a concentric reduction and a flexible symphysis, so it is used in children aged about 18 months to 6 years. Pemberton osteotomy is a related incomplete osteotomy that reshapes the acetabular roof.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric: Salter innominate osteotomy?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.