Dixon Sean M, Reddy Ravi P, Williams Dan, Fern Darren, Norton Mark R
Department of Orthopaedics, Royal Cornwall Hospital, Truro, UK;
Orthop Rev (Pavia). 2010 Mar 20;2(1):e1. doi: 10.4081/or.2010.e1.
Between January 2003 and December 2004, 13 patients underwent bilateral resurfacing arthroplasty via a Ganz trochanteric osteotomy. This bilateral group was mobilised fully weight-bearing with crutches. During the same period 139 Ganz trochanteric osteotomies were performed for unilateral hip resurfacing. These patients were mobilised with crutches, weight-bearing up to 10 kg on the operated leg. Nine osteotomies (32%) in the bilateral group subsequently developed a symptomatic non-union requiring revision of fixation. This compares with 10 patients (7%) in the unilateral group. Applying the Fisher's exact test, the difference reached significance (P=0.0004). In two patients a second revision was required to achieve union. In one patient, revision of trochanteric fixation precipitated a deep infection. Protected weight-bearing following a Ganz trochanteric osteotomy is important to the success of the procedure. Simultaneous bilateral hip arthroplasty through a Ganz approach should be avoided. If it is undertaken, we recommend that patients should be non weight-bearing for 6 weeks following surgery. Non-union following a Ganz trochanteric osteotomy for arthroplasty carries a significant morbidity.
2003年1月至2004年12月期间，13例患者通过甘兹转子截骨术接受了双侧表面置换关节成形术。该双侧手术组患者在使用拐杖的情况下完全负重活动。同期，为进行单侧髋关节表面置换术实施了139例甘兹转子截骨术。这些患者使用拐杖活动，术侧下肢负重达10千克。双侧手术组中有9例截骨术（32%）随后出现症状性骨不连，需要进行固定翻修。单侧手术组有10例患者（7%）出现这种情况。应用Fisher精确检验，差异具有统计学意义（P=0.0004）。有2例患者需要进行二次翻修才能实现骨愈合。有1例患者，转子固定翻修引发了深部感染。甘兹转子截骨术后进行保护性负重对手术成功至关重要。应避免通过甘兹入路同时进行双侧髋关节置换术。如果进行该手术，我们建议患者术后6周内不负重。用于关节成形术的甘兹转子截骨术后骨不连会带来严重的发病率。
