Padovani J P
Service d'Orthopédie et de Traumatologie Infantile, Hôpital des Enfants Malades, Paris, France.
Acta Orthop Belg. 1990;56(1 Pt B):275-86.
Pelvic osteotomies were proposed in order to preserve as much as possible of the acetabular cartilage. The aims were twofold: centering of the head of the femur in the acetabulum, to improve its stability; correction of the delay in growth of the acetabulum: there is a potential correction, allowing for the femoral growth, or a passive correction by widening a deep acetabulum. Two types of osteotomy are proposed: reorientation osteotomies (Salter, triple osteotomy) which have both a mechanical and biological effect and widening osteotomies (Chiari), which are in fact extracapsular arthroplasties. All the techniques of reorientation osteotomy are very similar and achieve a reorientation of the acetabulum on the femoral head by varization, retroversion and, when possible, medialization. The Chiari osteotomy, which is technically difficult, should be performed according to the very precise rules described by Chiari.
为尽可能保留髋臼软骨,人们提出了骨盆截骨术。其目的有两个:一是使股骨头在髋臼中居中,以提高其稳定性;二是纠正髋臼生长延迟:存在一种潜在的矫正方式,可适应股骨生长,或通过扩大深髋臼进行被动矫正。现提出两种截骨术:重新定向截骨术(如Salter截骨术、三联截骨术),具有机械和生物学效应;扩大截骨术(如Chiari截骨术),实际上是一种关节外成形术。所有重新定向截骨术技术都非常相似,通过内翻、后倾以及在可能情况下的内移,实现髋臼在股骨头上的重新定向。Chiari截骨术技术难度较大,应按照Chiari所描述的非常精确的规则进行操作。