Matsuda Dean K, Gupta Nikhil, Martin Hal D
Kaiser West Los Angeles Medical Center, Los Angeles, California, U.S.A.
Jefferson Medical College, Philadelphia, Pennsylvania, U.S.A.
Arthrosc Tech. 2014 Jan 10;3(1):e83-8. doi: 10.1016/j.eats.2013.08.013. eCollection 2014 Feb.
Femoral retroversion is an uncommon cause of cam femoroacetabular impingement that may require surgical treatment beyond arthroscopic or open femoroplasty. We present the case of a young adult with bilateral severe femoral retroversion in whom such treatment failed. We discuss the rationale, surgical technique, and outcome of this patient, who underwent bilateral closed intramedullary derotational proximal femoral osteotomies and interlocked nailing with adjunctive pre- and post-osteotomy hip arthroscopies. Clinical improvement with normal foot progression angles, radiographic union, and resolution of bilateral cam femoroacetabular impingement from femoral retroversion was achieved. This surgery permits rapid institution of weight-bearing ambulation and an early rehabilitative program. Femoral retroversion may be an underappreciated and insufficiently treated cause of cam femoroacetabular impingement that may be readily detected and successfully remedied with this less invasive procedure.
股骨后倾是凸轮型股骨髋臼撞击症的一种罕见病因，可能需要进行关节镜或开放股骨成形术以外的手术治疗。我们报告了一例双侧严重股骨后倾的年轻成人病例，其接受上述治疗失败。我们讨论了该患者接受双侧闭合髓内股骨近端去旋转截骨术及交锁髓内钉固定，并辅助截骨术前、后的髋关节镜检查的治疗原理、手术技术及结果。患者获得了临床改善，足部前进角度正常，影像学显示截骨愈合，双侧因股骨后倾导致的凸轮型股骨髋臼撞击症得到解决。该手术允许患者迅速开始负重行走及早期康复计划。股骨后倾可能是凸轮型股骨髋臼撞击症一个未得到充分认识和治疗的病因，通过这种侵入性较小的手术可以很容易地检测并成功纠正。
