Inan Muharrem, Gokce Alper, Ustunkan Fulya
Orthopaedic Department, Medical Faculty, Yeditepe University, Kozyatagi, 34752, Istanbul, Turkey.
Clin Orthop Relat Res. 2008 Apr;466(4):862-70. doi: 10.1007/s11999-008-0172-0. Epub 2008 Mar 12.
Periacetabular osteotomy has been recommended for reconstructing symptomatic dysplastic hips in adolescents and young adults, but requires substantial incisions and exposure. To minimize large incisions, we asked whether periacetabular osteotomy could be performed with a mini-incision under direct endoscopic control. We used five fresh-frozen cadaver pelves and developed curved guides and osteotomes for the osteotomy. We were able to perform a periacetabular osteotomy under endoscopic and image intensifier control and to fix the osteotomy with two cannulated screws. We identified no damage to vital structures or intraarticular fracture in any of the five cadavers we subsequently dissected. We believe periacetabular osteotomy may be performed with a mini-incision under direct endoscopic control. Our preliminary observations suggest the approach might be explored in limited prospective clinical trials by experienced individuals.
髋臼周围截骨术已被推荐用于重建青少年和年轻成人有症状的发育性髋关节发育不良，但需要较大的切口和暴露范围。为了尽量减少大切口，我们探讨了在直接内镜控制下通过小切口进行髋臼周围截骨术的可行性。我们使用了五具新鲜冷冻的尸体骨盆，并开发了用于截骨术的弯曲导向器和骨刀。我们能够在内镜和影像增强器的控制下进行髋臼周围截骨术，并用两枚空心螺钉固定截骨部位。在随后解剖的五具尸体中，我们均未发现重要结构受损或关节内骨折。我们认为，在直接内镜控制下可通过小切口进行髋臼周围截骨术。我们的初步观察结果表明，经验丰富的人员可在有限的前瞻性临床试验中探索这种方法。
