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前倾角调整的伯尔尼髋臼周围截骨术治疗脑瘫患儿神经源性髋关节发育不良

Anteverting Bernese periacetabular osteotomy in the treatment of neurogenic hip dysplasia in cerebral palsy.

作者信息

Georgiadis Andrew G, Dutt Vivek, Truong Walter H, Novotny Susan A, Novacheck Tom F

机构信息

Department of Orthopaedic Surgery, Gillette Children's Specialty Healthcare, St. Paul.

Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.

出版信息

J Pediatr Orthop B. 2018 Nov;27(6):473-478. doi: 10.1097/BPB.0000000000000513.

Abstract

All patients with hypertonic cerebral palsy undergoing Bernese periacetabular osteotomy (PAO) between 2005 and 2014 were reviewed. Clinical and radiographic parameters, including the cerebral palsy hip classification and anterior and posterior wall indices were collected to assess acetabular reorientation. Twenty (83%) of 24 procedures involved the correction of posterolateral acetabular insufficiency and were 'anteverting PAOs'. All 20 experienced improvements in radiographic indices. Eleven (58%) of 19 PAOs in ambulatory patients were performed in the setting of other multilevel orthopedic surgery. The anteverting PAO is successful in correcting the posterolateral acetabular insufficiency present in spastic hip dysplasia, and can be performed in conjunction with a single-event multilevel surgery.

摘要

对2005年至2014年间所有接受伯尔尼髋臼周围截骨术(PAO)的痉挛型脑瘫患者进行了回顾性研究。收集临床和影像学参数,包括脑瘫髋关节分级以及前后壁指数,以评估髋臼重新定位情况。24例手术中有20例(83%)涉及纠正髋臼后外侧不足,属于“前倾PAO”。所有20例患者的影像学指标均有改善。19例能行走患者中的11例(58%)的PAO手术是在其他多节段骨科手术的情况下进行的。前倾PAO在纠正痉挛性髋关节发育不良中存在的髋臼后外侧不足方面是成功的,并且可以与单期多节段手术联合进行。

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