Sakamoto Tetsuya, Naito Masatoshi, Nakamura Yoshinari
Department of Orthopaedic Surgery School of Medicine, Fukuoka University, Fukuoka, Japan.
Int Orthop. 2015 Nov;39(11):2281-6. doi: 10.1007/s00264-015-2973-6. Epub 2015 Aug 29.
Peri-acetabular osteotomy, especially curved peri-acetabular osteotomy, is an effective surgical procedure for re-orientating the acetabulum. However, there have been few reports on this procedure in teenagers. The purpose of this study was to investigate the treatment outcomes of curved peri-acetabular osteotomy in teenagers.
We retrospectively reviewed 33 hips in 27 teenage patients with acetabular dysplasia who underwent curved peri-acetabular osteotomy between 1995 and 2012. The mean age was 17.0 years (range, 14-19 years). The mean follow-up duration at the most recent physical examination was 33.3 months (range, 24-96 months). All hips were evaluated in terms of the Harris hip score, radiographic measurements, and complications.
The mean Harris hip score improved from 80.1 points pre-operatively to 95.4 points post-operatively (p < 0.001). There were significant differences in all of the radiographic measurements between the pre-operative and post-operative values (p < 0.001). One major complication occurred (symptomatic ischial nonunion) and required subsequent surgery. Nine hips had minor complications, including nonunion of the superior ramus osteotomy (four hips), superficial stitch abscess (two hips), and transient lateral femoral cutaneous nerve palsy (three hips).
Satisfactory results can be obtained clinically and radiographically after curved peri-acetabular osteotomy in adolescents. Osteotomy for acetabular dysplasia is effective in teenagers.
髋臼周围截骨术，尤其是弧形髋臼周围截骨术，是一种重新定位髋臼的有效手术方法。然而，关于青少年进行该手术的报道较少。本研究的目的是探讨青少年弧形髋臼周围截骨术的治疗效果。
我们回顾性分析了1995年至2012年间接受弧形髋臼周围截骨术的27例青少年髋臼发育不良患者的33个髋关节。平均年龄为17.0岁（范围14 - 19岁）。在最近一次体格检查时的平均随访时间为33.3个月（范围24 - 96个月）。所有髋关节均根据Harris髋关节评分、影像学测量和并发症进行评估。
Harris髋关节评分平均从术前的80.1分提高到术后的95.4分（p < 0.·001）。术前和术后所有影像学测量值均有显著差异（p < 0.·001）。发生了1例主要并发症（有症状的坐骨骨不连），需要后续手术。9个髋关节有轻微并发症（包括上支截骨骨不连4例、浅表缝线脓肿2例、股外侧皮神经短暂性麻痹3例）。
青少年弧形髋臼周围截骨术后在临床和影像学上均可获得满意结果。髋臼发育不良截骨术对青少年有效。
