Hamai Satoshi, Nakashima Yasuharu, Akiyama Mio, Kuwashima Umito, Yamamoto Takuaki, Motomura Goro, Ohishi Masanobu, Iwamoto Yukihide
Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan,
Int Orthop. 2014 Oct;38(10):2051-6. doi: 10.1007/s00264-014-2375-1. Epub 2014 May 27.
Ischio-pubic stress fracture is one of the potential complications after peri-acetabular osteotomy (PAO) in patients with hip dysplasia. The purpose of this study was to examine the prevalence of and risk factors for ischio-pubic fractures following PAO.
A total of 296 hips in 275 patients who underwent transposition osteotomy of the acetabulum between 2001 and 2012 were retrospectively reviewed. Patient characteristics and radiographic parameters were compared between patients with and without fracture.
Fourteen ipsilateral hips (4.7%) in 14 female patients had fracture of the inferior pubic ramus (11 hips) or the ischial ramus (three hips) on the same side as the surgery at an average of 4.6 weeks after PAO. Multivariate analysis indicated that younger age at operation (odds ratio of 1.43 per five years, p = 0.0169) and greater degree of correction (odds ratio of 1.98 per five degrees, p = 0.0005) were significantly associated with ischio-pubic fracture as independent risk factors. All fractures healed conservatively with partial weight-bearing.
Younger female patients and greater deformity corrections increased the risk of ischio-pubic stress fracture after PAO.
坐骨耻骨应力性骨折是髋臼发育不良患者髋臼周围截骨术（PAO）后潜在的并发症之一。本研究旨在探讨PAO术后坐骨耻骨骨折的发生率及危险因素。
回顾性分析2001年至2012年间275例接受髋臼转位截骨术的患者共296髋。比较骨折患者与未骨折患者的患者特征和影像学参数。
14例女性患者的14个同侧髋关节（4.7%）在PAO术后平均4.6周出现与手术同侧的耻骨下支骨折（11髋）或坐骨支骨折（3髋）。多因素分析表明，手术时年龄较小（每5岁比值比为1.43，p = 0.0169）和矫正程度较大（每5度比值比为1.98，p = 0.0005）作为独立危险因素与坐骨耻骨骨折显著相关。所有骨折均通过部分负重保守治疗愈合。
年轻女性患者和更大的畸形矫正增加了PAO术后坐骨耻骨应力性骨折的风险。
