Windhager R, Lack W, Schiller C, Kotz R
Orthopädische Universitätsklinik, Wien.
Z Orthop Ihre Grenzgeb. 1990 Nov-Dec;128(6):575-83. doi: 10.1055/s-2008-1040008.
On the basis of 63 Salter pelvic osteotomies which were performed in 57 patients with congenital dislocation and subluxation of the hip between 1970 and 1986 at the Orthopaedic University Clinic of Vienna, we tried to work out the reasons for the rate of failures of 29% in our material. The mean age at operation was 4.1 years (1.5-18), that at follow up 15.7 years (4.6-28). We based our assessments on the clinical and radiological criteria of the Commission for the Study of Hip Dysplasia of the German Society of Orthopaedics and Traumatology. The number of failures at follow up (hip value III + IV) increased from 25%, if the operation was done before the age of four years, to 41%, if it was performed at a later age. In the latter group we were not able to observe any spontaneous improvement, which was typical for the younger age group. A moderately pathologic hip dysplasia (hip value III) could be improved to a normal value at follow up in 87%, an extremely pathologic one just in 50% of the cases. In just some of the patients we found postoperatively a tilt of the distal pelvic fragment, which could be registered by the oval shape of the foramen obturatum. Above all in young children a pelvic tilt was rare because of the elasticity of the triradiate cartilage. Out of 37 evaluable cases a tilt of the distal pelvic fragment by the operation could be verified in only 12 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
1970年至1986年间，在维也纳大学骨科诊所对57例先天性髋关节脱位和半脱位患者实施了63例Salter骨盆截骨术。基于这些病例，我们试图找出我们所治疗病例中出现29%失败率的原因。手术时的平均年龄为4.1岁（1.5 - 18岁），随访时的平均年龄为15.7岁（4.6 - 28岁）。我们依据德国骨科与创伤外科学会髋关节发育不良研究委员会的临床和放射学标准进行评估。随访时失败的病例数（髋关节评级III + IV），若手术在4岁前进行，为25%；若在更大年龄进行，则增至41%。在后一组中，我们未观察到任何自发改善情况，而这在较年轻年龄组中是典型现象。中度病理性髋关节发育不良（髋关节评级III）在随访时87%可改善至正常评级，而极度病理性的仅50%能改善。仅部分患者术后出现远端骨盆碎片倾斜，可通过闭孔呈椭圆形得以记录。尤其是幼儿，由于三叶软骨的弹性，骨盆倾斜很少见。在37例可评估病例中，仅12例证实手术导致了远端骨盆碎片倾斜。（摘要截选至250词）
