Professor W. Dega, working in Poznan, Poland, described an incomplete iliac osteotomy in 1969. Reported just a few years after Pemberton’s osteotomy, the Dega osteotomy was part of a continuum of incomplete osteotomies that also include the Pembersal and the San Diego osteotomies. These osteotomies correct the acetabulum but maintain hinges on portions of the symphysis pubis and the triradiate cartilage (Fig. 16-1). Because of this second point of hinging, these osteotomies have the potential not only to reorient the acetabulum but also to reshape it. They differ in the extent of the bone cut on the inner and outer tables of the acetabulum—the extent of the remaining hinge. The Pemberton procedure cuts both the inner and the outer tables of the ilium, hinges on the ischial limb of the triradiate cartilage, and extends past the ischial limb of the triradiate cartilage, freeing the acetabulum to rotate more. The San Diego osteotomy preserves the entire medial cortex and cuts through the cortical bone of the sciatic notch in an attempt to produce equal anterior and posterior coverage. The Dega osteotomy preserves the inner table of the pelvis posterior to the iliopectineal line. It also preserves the entire cortex of the sciatic notch, forming a hinge to provide more anterior and lateral femoral head coverage. The exciting aspect, however, about the Dega osteotomy is its versatility in providing femoral head coverage in any direction based on where the ilium is left intact. If the osteotomy is extended through the sciatic notch, instead of stopping short of it, then the medial cortex of the midilium acts as a hinge, which helps to provide more posterior coverage. This modification makes the Dega osteotomy look quite similar to the San Diego osteotomy.

This chapter presents the Dega osteotomy surgical technique, which provides anterior and lateral coverage as classically described by Dega, and discusses its potential modifications.