Pucher A, Ruszkowski K, Bernardczyk K, Nowicki J
Orthopaedic Department, K. Marcinkowski University of Medical Sciences, Poznań, Poland.
J Pediatr Orthop. 2000 May-Jun;20(3):311-6.
A series of 49 patients (55 hips) who had distal greater trochanteric transfer at the mean age of 13.9 years because of the deformity of the proximal femur after treatment for developmental dislocation of the hip was reviewed to verify the value of the procedure. Mean follow-up was 8.8 years. Clinical and radiologic assessment was supplemented with strain-gauging evaluation of the muscles involved. Good results were achieved in patients who had good range of movement or isolated restriction of abduction before the operation. After surgery, a 22% increase of abductors torque was found, the Trendelenburg sign disappeared in 30 individuals, and 15 patients regained normal gait. No complications were observed. Our study confirmed the value of distal transfer of the greater trochanter in treatment for proximal femur deformity owing to avascular necrosis after management of developmental dislocation of the hip and clarified indications for this procedure.
对49例患者（55髋）进行了回顾性研究，这些患者因发育性髋关节脱位治疗后股骨近端畸形，平均在13.9岁时进行了大转子远端转移术，以验证该手术的价值。平均随访时间为8.8年。临床和放射学评估辅以对相关肌肉的应变计评估。术前活动范围良好或仅有外展受限的患者取得了良好的效果。术后发现外展肌扭矩增加了22%，30例患者的Trendelenburg征消失，15例患者恢复了正常步态。未观察到并发症。我们的研究证实了大转子远端转移术在治疗发育性髋关节脱位后因缺血性坏死导致的股骨近端畸形中的价值，并明确了该手术的适应证。
