Paediatric orthopaedics: Pemberton 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 orthopaedics: Pemberton osteotomy

Sample item

A 2-year-old with residual acetabular dysplasia needs a redirection procedure that is an incomplete cut through the ilium just above the acetabulum, hinging on the triradiate cartilage, and that reduces acetabular volume. Which procedure is this?

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

The answer and the reasoning

D. Pemberton pericapsular osteotomy

Pemberton's osteotomy is an incomplete pericapsular iliac cut that hinges at the triradiate cartilage, redirects the acetabular roof and reduces its volume, so it is suited to a large, capacious acetabulum. Salter's osteotomy is complete and hinges at the symphysis pubis without altering volume.

Option by option

  • A. Steel triple osteotomy

    The Steel osteotomy cuts the ilium, ischium and pubis and is used for older children.

  • B. Chiari medial displacement osteotomy

    Chiari osteotomy medialises the pelvis above the joint as a salvage and does not use the triradiate hinge.

  • C. Salter innominate osteotomy

    Salter's osteotomy is a complete innominate cut with rotation at the symphysis pubis.

  • D. Pemberton pericapsular osteotomy (correct)

    Correct. An incomplete cut hinging at the triradiate cartilage characterises it.

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 D, Pemberton pericapsular osteotomy. Pemberton's osteotomy is an incomplete pericapsular iliac cut that hinges at the triradiate cartilage, redirects the acetabular roof and reduces its volume, so it is suited to a large, capacious acetabulum.

Why is "Steel triple osteotomy" not the answer?

The Steel osteotomy cuts the ilium, ischium and pubis and is used for older children.

Why is "Chiari medial displacement osteotomy" not the answer?

Chiari osteotomy medialises the pelvis above the joint as a salvage and does not use the triradiate hinge.

Why is "Salter innominate osteotomy" not the answer?

Salter's osteotomy is a complete innominate cut with rotation at the symphysis pubis.

What concept does this question test?

It tests Paediatric orthopaedics: Pemberton osteotomy in Orthopaedics. Salter's osteotomy is complete and hinges at the symphysis pubis without altering volume.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 orthopaedics: Pemberton 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.