Publication At A Glance

Triangle Tilt and Steel Osteotomy: Similar Approaches to Common Problems

Each year, thousands of children suffer brachial plexus nerve injuries at birth. These injuries affect the children on multiple levels. The primary injury is nerve damage and the secondary injuries consist of muscle and bone deformities.

The Triangle Tilt surgery was developed to address the dislocation of the shoulder joint. This dislocation occurs because of muscle imbalances and results in poor shoulder development as well as visible deformities. Early shoulder arthritis is also said to occur. The Steel Pelvic Osteotomy was developed to address hip dysplasia (from multiple causes).

We studied the two procedures and found that there are interesting similarities:

Both surgeries involve limb girdles and ball-and-socket joints.
Both surgeries involve three deliberate bone rotations (osteotomies). For the Triangle Tilt, the acromion, clavicle and scapula are repositioned. For the Steel Pelvic Osteotomy, the iliac spine, ischial and pubic ramus of the innominate bone are repositioned.

Post operative CT scans for both surgeries show improvement in the positioning of the ball-and-socket joint thus bringing about greater functional abilities.

The two surgical procedures and post operative results are based on similar anatomic deformities and result in improvement of the joint.