Rush J
Department of Orthopaedic Surgery, St Vincent's Hospital, Fitzroy, Victoria.
Aust N Z J Surg. 1991 Oct;61(10):761-4.
For almost 20 years the Chiari pelvic displacement osteotomy has been used as a method of providing cover to the femoral head in cases of acetabular dysplasia. The osteotomy is one of a number of procedures that have been used in an attempt to prevent the early development of secondary osteo-arthritis and the need for total hip replacement. More recently, the operation has been undertaken in cases where there is already some arthritic change. This long-term review of 18 Chiari operations shows that the procedure was successful in cases of acetabular dysplasia where there was minimal subluxation of the femoral head (i.e. with Shenton's line still intact). In more advanced cases where there was significant subluxation (i.e. with Shenton's line broken by more than 1 mm) and even early arthritic changes, the results were poor. It is concluded that the operation may be of value as an almost 'prophylactic' procedure but that it is of no value as a so-called 'salvage' procedure.
近20年来，Chiari骨盆截骨术一直被用作髋臼发育不良病例中为股骨头提供覆盖的一种方法。该截骨术是为防止继发性骨关节炎早期发展和避免全髋关节置换需求而采用的多种手术之一。最近，该手术也在已有一些关节炎改变的病例中开展。这项对18例Chiari手术的长期回顾表明，在股骨头半脱位程度极小（即Shenton线仍完整）的髋臼发育不良病例中，该手术是成功的。在股骨头半脱位明显（即Shenton线中断超过1毫米）甚至已有早期关节炎改变的更严重病例中，手术效果不佳。结论是，该手术作为一种近乎“预防性”的手术可能有价值，但作为一种所谓的“挽救性”手术则毫无价值。
