Schoeniger Ralf, LaFrance Amy E, Oxland Thomas R, Ganz Reinhold, Leunig Michael
Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
Clin Orthop Relat Res. 2009 Mar;467(3):775-82. doi: 10.1007/s11999-008-0668-7. Epub 2008 Dec 16.
The use of a trochanteric slide osteotomy needs a partial weightbearing period to allow safe healing of the osteotomy. We compared the initial rigidity of fixation of the trochanteric slide osteotomy with that of a newly developed technique, the trochanteric step osteotomy. The slide and step osteotomies were tested on six bilateral pairs of cadaveric femora with cyclic shear load of constant amplitude for 100 cycles in both a superior direction to represent standing and 60 degrees of hip flexion to represent a squat stance. Translational and rotational migration and cyclic amplitude were measured with an optoelectronic camera system. During superior loading, translational migration of the slide osteotomy was greater than for the step osteotomy (slide median, 1.7 mm; step median, 0.3 mm), but rotational migration was not (slide median, 1.9 degrees; step median, 0.2 degrees ). Translational amplitude was greater for the slide osteotomy in the superior direction (median slide, 0.3 mm; median step, 0.16 mm), but not in rotational amplitude. Similar trends in migration and amplitude were observed for the squat loading configuration. The data suggest the trochanteric step osteotomy is a more stable construct than the commonly performed slide osteotomy.
使用转子滑动截骨术需要一段部分负重期，以确保截骨部位安全愈合。我们比较了转子滑动截骨术与一种新开发技术——转子阶梯截骨术的初始固定刚度。在六对双侧尸体股骨上对滑动截骨术和阶梯截骨术进行测试，施加恒定幅度的循环剪切载荷，在代表站立的向上方向进行100次循环，以及在代表深蹲姿势的髋关节屈曲60度时进行100次循环。使用光电摄像系统测量平移和旋转位移以及循环幅度。在向上加载过程中，滑动截骨术的平移位移大于阶梯截骨术（滑动截骨术的中位数为1.7毫米；阶梯截骨术的中位数为0.3毫米），但旋转位移并非如此（滑动截骨术的中位数为1.9度；阶梯截骨术的中位数为0.2度）。在向上方向上，滑动截骨术的平移幅度更大（滑动截骨术的中位数为0.3毫米；阶梯截骨术的中位数为0.16毫米），但旋转幅度并非如此。在深蹲加载配置中也观察到了类似的位移和幅度趋势。数据表明，转子阶梯截骨术是一种比常用的滑动截骨术更稳定的结构。
