Beck M, Leunig M, Ellis T, Sledge J B, Ganz R
Department of Orthopedic Surgery, University of Bern, Inselspital, 3010, Bern, Switzerland.
Surg Radiol Anat. 2003 Nov-Dec;25(5-6):361-7. doi: 10.1007/s00276-003-0149-3. Epub 2003 Aug 16.
As the popularity of juxta-acetabular osteotomies in adults increases, concern arises that such a procedure will potentially cause avascular necrosis of the acetabular fragment. In order to verify the remaining vascularization after a Bernese periacetabular osteotomy, an injection study with colored latex was performed. The vascularity of the outside of the periacetabular bone was studied in 16 hips after injection of colored latex into the abdominal aorta and the inside in four hips. To confirm the conclusions drawn from the anatomic study, a Bernese periacetabular osteotomy was performed in two additional hips after latex injection. This study demonstrated that through a modified Smith-Peterson approach and with execution of the osteotomies from the inside of the pelvis the acetabular fragment remains vascularized by the supra-acetabular and acetabular branches of the superior gluteal artery, the obturator artery and the inferior gluteal artery. Some uncertainty remains about how much correction is tolerated by the smaller blood vessels.
随着成人髋臼周围截骨术的普及，人们开始担心这种手术可能会导致髋臼碎片的缺血性坏死。为了验证伯尔尼髋臼周围截骨术后剩余的血管化情况，进行了一项彩色乳胶注射研究。在向腹主动脉注射彩色乳胶后，对16个髋关节的髋臼周围骨外侧的血管分布进行了研究，并对4个髋关节的内侧进行了研究。为了证实从解剖学研究得出的结论，在注射乳胶后又对另外两个髋关节进行了伯尔尼髋臼周围截骨术。这项研究表明，通过改良的史密斯-彼得森入路并从骨盆内部进行截骨，髋臼碎片仍由臀上动脉的髋臼上支和髋臼支、闭孔动脉及臀下动脉供血。对于较小血管能够耐受多大程度的矫正仍存在一些不确定性。
