Sankar Wudbhav N
Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
J Pediatr Orthop. 2013 Jul-Aug;33 Suppl 1:S39-44. doi: 10.1097/BPO.0b013e3182770a71.
Neurogenic conditions and syndromes are often associated with clinically significant acetabular dysplasia and/or instability of the hip. Options for surgical treatment include reshaping, salvage, or redirectional pelvic osteotomies. "Complete" redirectional osteotomies, including the triple innominate osteotomy and the periacetabular osteotomy, completely free the acetabulum from the rest of the pelvis thereby allowing the surgeon to obtain large corrections and to control the position of the acetabulum in multiple planes. As a result, these procedures can be extremely useful in the treatment of certain neuromuscular conditions. In particular, complete redirectional osteotomies offer several specific advantages in the neurogenic and syndromic patient population: the procedures can be performed after skeletal maturity, they offer the surgeon the ability to correct acetabular version and the hypoplastic acetabulum, they allow hypercoverage when necessary and they may theoretically better preserve marginal ambulatory ability.
神经源性疾病和综合征常与具有临床意义的髋臼发育不良和/或髋关节不稳定相关。手术治疗方案包括髋臼重塑、挽救性手术或骨盆重定向截骨术。“完全”重定向截骨术，包括三联骨盆截骨术和髋臼周围截骨术，将髋臼与骨盆的其余部分完全分离，从而使外科医生能够进行大幅度矫正并在多个平面上控制髋臼的位置。因此，这些手术在治疗某些神经肌肉疾病时可能极为有用。特别是，完全重定向截骨术在神经源性和综合征患者群体中具有几个特定优势：这些手术可在骨骼成熟后进行，使外科医生能够矫正髋臼方向和发育不良的髋臼，必要时可实现髋臼过度覆盖，并且理论上可能更好地保留边缘行走能力。
