Dega osteotomy

Introduction

Dega osteotomy is also known as a pelvic osteotomy. It is a procedure used to:

• correct hips that are not developing properly
• correct hip dislocation
• prevent hip dislocation
• reduce pain in the hip.

Children with overly tight or weak muscles or who cannot walk can have hip joints that do not develop properly. Children with cerebral palsy may have these issues, as the sockets of their hip joints can be very shallow and flat. When hip joints do not develop properly, they are at risk of dislocating as your child grows. If this happens, they will need surgery.

Before your child has a dega osteotomy, it is important to:

• make sure your child’s therapists know about the upcoming procedure
• contact your local physiotherapist or occupational therapist to go on their waitlist for an appointment after surgery
• let your child’s school know about the procedure and that they may be off school for several weeks 
• arrange time off for yourself around the surgery date and let family and friends know so they can provide some support if needed
• let the hospital know as soon as possible if your child becomes sick before their procedure date, as it may need to be rescheduled.

Your child will be under a general anaesthetic for the operation, which means they will be asleep and will not feel any pain.

In the dega osteotomy: 

1. a cut is made into the pelvis above the socket of the hip joint 
2. the top part of the flat hip socket is turned down to create a more cup-like shape, which fits better around the bone and holds it in the correct position
3. the new position of the socket is held with a small block of bone taken from the thigh or the top part of the pelvis. 

The procedure can be done on one or both hips if needed.

Your child will be given pain medication when they wake up from surgery. Pain management in the hospital is done either by a nerve block, an intravenous drip or oral medicine. Your child may stay in the hospital 5-7 days after the procedure.

Your child will not be allowed to weight bear or support the weight of their body for 4-6 weeks after surgery. This will depend on the surgeon and the strength of your child’s bones.

Your child may need to be positioned with their legs apart after surgery to help the hips heal. They may need to use a device like a brace or a foam wedge. An occupational therapist can organise this.

Caring for your child at home

Your child might need to use equipment to help with movement and everyday activities while they recover. Equipment can include a wheelchair and a commode, a special chair that makes toileting and showering easier. Your child will see an occupational therapist who will help you organise equipment.

The hospital will make sure you have pain medicine and instructions for your child when you take them home from the hospital. It is important to follow the pain medication instructions carefully, giving them before moving from one position to another, showering and toileting.

Check your child’s skin regularly for redness and pain. These are pressure areas that can develop into sores. Pressure sores are severe if left untreated.