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[儿童及成人发育性髋关节发育不良的骨盆三联截骨术]

[Triple osteotomy of the pelvis in dysplastic hip joints in children and adults].

作者信息

Schulitz K P, Roggenland G

机构信息

Orthopädische Klinik, Heinrich-Heine-Universität Düsseldorf.

出版信息

Z Orthop Ihre Grenzgeb. 1991 May-Jun;129(3):209-16. doi: 10.1055/s-2008-1040185.

Abstract

We report on a post operative radiological and clinical follow-up (3-6.4 years) of 80 triple-osteotomies (29 operations according to the technique of Carlioz and 51 according to Tönnis). This study includes 32 osteotomies in children and 48 in adults. In 82% of the cases of low dysplastic hip joints and in 88% of the cases in severe dysplastic hip joints, the results came up to the expectations of the patients. The acetabular inclination angle and the acetabular angle improved about 10 degrees and the center edge angle about 25 degrees. In cases of neurological diseases, the radiological results of the hips were less satisfactory. The results is negatively influenced by pseudarthrosis and stress fractures in the ischium. These complications occur to a lower degree after Tönnis-osteotomy. From the age of 7, the triple-osteotomy represents an useful alternative to the operative correction of the hip joint dysplasia. The operation can be carried out in cases of congruity of head and acetabulum. Under certain circumstances, a transposition operation is additionally necessary, it is only indicated with a coxa valga. The triple-osteotomy can positively influence the biomechanical situation of the hip joint by means of an improved head roofing, by an ameliorated adjoining of the area of force reception to the pressure resultant and by medialisation of the acetabulum.

摘要

我们报告了80例三联截骨术的术后影像学及临床随访结果(随访时间3 - 6.4年),其中29例采用卡里奥兹(Carlioz)技术,51例采用托尼尼斯(Tönnis)技术。本研究包括32例儿童截骨术和48例成人截骨术。在轻度发育不良髋关节病例中,82%的结果达到了患者的期望;在重度发育不良髋关节病例中,这一比例为88%。髋臼倾斜角和髋臼角改善了约10度,中心边缘角改善了约25度。在患有神经疾病的病例中,髋关节的影像学结果不太理想。坐骨假关节和应力性骨折对结果有负面影响。这些并发症在托尼尼斯截骨术后的发生率较低。从7岁起,三联截骨术是髋关节发育不良手术矫正的一种有用替代方法。在股骨头与髋臼匹配的情况下可以进行该手术。在某些情况下,还需要进行转位手术,仅在髋外翻时适用。三联截骨术可通过改善股骨头覆盖、改善受力区域与压力合力的毗邻关系以及髋臼内移,对髋关节的生物力学状况产生积极影响。

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