Placzek R, Gathen M, Koob S, Jacobs C, Ploeger M M
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
Oper Orthop Traumatol. 2018 Oct;30(5):379-386. doi: 10.1007/s00064-018-0561-9. Epub 2018 Aug 8.
Growth disorders (e. g. caused by congenital hip dislocation, Perthes disease or bacterial coxitis) often lead to an infantile deformity of the proximal femur with a shortened femoral neck and displaced grater trochanter. In 1988, Morscher and Buess described a femoral neck lenghtening osteotomy for treatment of adults. For the first time, we show a modification of this osteotomy for children and adolescents with a locking plate system. The aim is to restore the normal anatomy of the femoral neck and biomechanics of the proximal femur.
All symptomatic deformities of the proximal femur with a shortened femoral neck and a proximal displacement of the greater trochanter.
Bacterial coxitis within the last two years; elevated infections parameters. Acetabular dysplasia with a lack of femoral head containment.
Two osteotomies: one at the level of the greater trochanter to transfer it. The second osteotomy at the level of the distal femoral neck. Stabilization with a locking plate system (LCP Pediatric Hip Plate 130°, Synthes, Oberdorf, Switzerland).
Full weight bearing to a body weight of 55 kg; partial weight bearing with a body weight >55 kg for 6 weeks.
No intraoperative or postoperative complications were observed in 5 female patients (mean age 11.67 years). After a follow-up of 6-12 weeks, none of the patients presented a Trendelenburg's sign. After 3-6 months, full range of motion was possible.
生长发育障碍（如由先天性髋关节脱位、佩特兹病或细菌性髋关节炎引起）常导致股骨近端出现婴儿型畸形，伴有股骨颈缩短和大转子移位。1988年，莫舍尔和布斯描述了一种用于治疗成人的股骨颈延长截骨术。我们首次展示了一种针对儿童和青少年的改良截骨术，采用锁定钢板系统。目的是恢复股骨颈的正常解剖结构和股骨近端的生物力学。
所有有症状的股骨近端畸形，伴有股骨颈缩短和大转子近端移位。
过去两年内患有细菌性髋关节炎；感染参数升高。髋臼发育不良且股骨头包容不足。
两次截骨：一次在大转子水平进行转移截骨。第二次截骨在股骨颈远端水平。用锁定钢板系统（130°小儿髋关节钢板，辛迪斯公司，瑞士奥伯多夫）固定。
体重55千克以下可完全负重；体重超过55千克时部分负重6周。
5名女性患者（平均年龄11.67岁）未观察到术中或术后并发症。随访6至12周后，所有患者均未出现臀中肌步态。3至6个月后，可实现全范围活动。
