McNerney N P, Mubarak S J, Wenger D R
Children's Hospital, San Diego, California, USA.
J Pediatr Orthop. 2000 Jan-Feb;20(1):93-103.
Ninety-two patients with cerebral palsy underwent a special type of pericapsular acetabuloplasty designed to correct the hip dysplasia that occurs in cerebral palsy. The osteotomy was performed as part of a combined procedure (including femoral osteotomy and soft-tissue releases). Retrospective analysis was performed on 75 of the children (104 hips from 1982 through 1995) with a mean follow-up of 6.9 years. Ninety-nine (95%) of the 104 hips remained well reduced at follow-up. There were no redislocations. If the preoperative migration percentage was >70% (severe subluxation), improved results were noted in hips that had an open reduction with capsulorrhaphy. There were 13 complications including intraarticular extension of the acetabuloplasty (one) and avascular necrosis of the femoral head (eight hips, 8%). Indications for addition of a pericapsular acetabuloplasty include an open triradiate cartilage, acetabular dysplasia (acetabular index >25 degrees), and subluxation or dislocation with a migration percentage of >40%. Even hips with relative incongruity and some deformity of the femoral head can be successfully treated with this combined approach.
92例脑瘫患者接受了一种特殊类型的髋臼周围截骨术，旨在纠正脑瘫患者出现的髋关节发育不良。该截骨术作为联合手术（包括股骨截骨术和软组织松解术）的一部分进行。对75例儿童（1982年至1995年的104个髋关节）进行回顾性分析，平均随访6.9年。随访时，104个髋关节中有99个（95%）复位良好。无再脱位情况。如果术前移位百分比>70%（严重半脱位），行切开复位加关节囊缝合术的髋关节效果改善。共有13例并发症，包括髋臼截骨术关节内延伸（1例）和股骨头缺血性坏死（8个髋关节，8%）。髋臼周围截骨术的适应证包括开放的Y形软骨、髋臼发育不良（髋臼指数>25度）以及移位百分比>40%的半脱位或脱位。即使是股骨头相对不匹配且有一些畸形的髋关节，采用这种联合方法也能成功治疗。
