Lack W, Feldner-Busztin H, Ritschl P, Ramach W
Department of Orthopaedics, University of Vienna, Austria.
J Pediatr Orthop. 1989 Mar-Apr;9(2):197-204.
We report the clinical and radiological results following intertrochanteric varus osteotomy and Chiari pelvic osteotomy for Perthes' disease in 70 hips with a minimum follow-up of 3 years. The indication depended on lateralization of the epiphysis of the femoral head with or without full containment in the abduction radiograph, thickening of the acetabular floor, coxa magna, and osteoarthritis. Epiphyseal quotient and sphericity showed that head deformity is mostly permanent; the acetabulum-head quotient provided good coverage. Operation in the condensation stage achieved far better results than later operations. From these and other results, the late and mild occurrence of osteoarthritis can be assumed despite deformed femoral head or acetabulum, with full coverage provided.
我们报告了70例髋关节佩特兹病采用转子间内翻截骨术和Chiari骨盆截骨术治疗后的临床及影像学结果,最短随访时间为3年。手术指征取决于股骨头骨骺的外移情况,在外展X线片上股骨头骨骺有无完全包容、髋臼底增厚、大转子增大以及骨关节炎情况。骨骺商和球形度显示股骨头畸形大多是永久性的;髋臼-股骨头商提供了良好的覆盖。在凝结期进行手术比后期手术取得的效果好得多。从这些及其他结果可以推测,尽管股骨头或髋臼畸形,但只要有充分的覆盖,骨关节炎的发生就会较晚且程度较轻。