Mahran Mahmoud A, Elgebeily Mohamed A, Ghaly Nabil A M, Thakeb Mootaz F, Hefny Hany M
Orthopedic department, Ain Shams University Medical School and Hospitals, Cairo, Egypt.
Strategies Trauma Limb Reconstr. 2011 Apr;6(1):13-20. doi: 10.1007/s11751-011-0104-5. Epub 2011 Mar 1.
For evaluating pelvic support osteotomy as a salvage procedure in managing neglected hip problems in adolescents and young adults, PSO was performed for 20 hips in 20 patients (5 men and 15 women). The mean age was 21.5 years. The etiology was neglected developmental dysplasia of the hip in 9 patients, post-septic hip sequelae in 9 patients, and paralytic dislocation due to poliomyelitis in 2 patients. All patients were treated by two osteotomies: a proximal femoral osteotomy to support the pelvis and correct the flexion and rotational deformities of the hip and a distal varization and lengthening osteotomy. Final clinical evaluation was done 6 months after frame removal. The mean external fixation time was 6.4. Lengthening and mechanical axis parallelism was achieved in all patients. At the final follow-up and according to a predesigned scoring system, there were 7(35%) excellent results, 6(30%) good results, 7(35%) fair results, and no poor results. Hip reconstruction by Ilizarov's concept can be technically demanding and involving lengthy period wearing the frame but found to be a valuable salvage procedure for numerous neglected hip problems particularly in young patients.
为评估骨盆支撑截骨术作为挽救手术治疗青少年和年轻成人被忽视的髋部问题的效果，对20例患者（5例男性和15例女性）的20髋实施了骨盆支撑截骨术（PSO）。平均年龄为21.5岁。病因包括9例被忽视的发育性髋关节发育不良、9例感染后髋部后遗症以及2例因脊髓灰质炎导致的麻痹性脱位。所有患者均接受了两次截骨术：一次股骨近端截骨以支撑骨盆并纠正髋部的屈曲和旋转畸形，另一次是远端内翻延长截骨术。在去除外固定架6个月后进行最终临床评估。平均外固定时间为6.4个月。所有患者均实现了延长且机械轴平行。在最终随访时，根据预先设计的评分系统，结果为优7例（35%）、良6例（30%）、可7例（35%），无差的结果。采用伊里扎洛夫理念进行髋关节重建在技术上要求较高且需长时间佩戴外固定架，但对于众多被忽视的髋部问题，尤其是年轻患者而言，是一种有价值的挽救手术。
