Vasseur L, Ayoub B, Mesnil P, Pasquier G, Migaud H, Girard J
Université de Lille, 59000 Lille, France; Service d'orthopédie C, hôpital Salengro, CHU de Lille, place de Verdun, 59000 Lille, France.
Université de Lille, 59000 Lille, France; Service d'orthopédie C, hôpital Salengro, CHU de Lille, place de Verdun, 59000 Lille, France.
Orthop Traumatol Surg Res. 2015 Apr;101(2):247-9. doi: 10.1016/j.otsr.2014.12.014. Epub 2015 Mar 6.
Correction of leg length discrepancy during hip arthroplasty is a technical challenge. Although resurfacing proposed to young subjects presents a number of advantages (stability, bone stock, etc.), it does not correct leg length discrepancy. We propose an original femoral lengthening technique concomitant to resurfacing performed through the same approach, consisting in a Z-shaped subtrochanteric osteotomy. Resurfacing was performed first and the femoral and acetabular reaming material was used for autografting. The series comprised five cases followed for a mean 42.2 months (range, 33-64 months). The mean surgical time was 100 min (range, 76-124 min). Weightbearing was authorized in all cases at the 8th week. The mean lengthening was 32 mm (range, 25-40 mm). Healing was observed in all cases. This surgical technique, reserved for very young subjects who accept an 8-week postoperative period without weightbearing, can be proposed in cases with substantial preoperative leg length discrepancy.
髋关节置换术中纠正肢体长度差异是一项技术挑战。尽管针对年轻患者的表面置换术具有诸多优势（稳定性、骨量等），但它无法纠正肢体长度差异。我们提出一种与表面置换术同时进行的独特股骨延长技术，通过相同的入路实施，该技术包括Z形转子下截骨术。首先进行表面置换，并用股骨和髋臼扩髓材料进行自体骨移植。该系列包括5例患者，平均随访42.2个月（范围为33 - 64个月）。平均手术时间为100分钟（范围为76 - 124分钟）。所有病例均在第8周允许负重。平均延长长度为32毫米（范围为25 - 40毫米）。所有病例均观察到愈合情况。这种手术技术适用于接受术后8周不负重的非常年轻的患者，对于术前存在明显肢体长度差异的病例可以考虑采用。
