Lara Joaquín, Villegas Diego, Besomi Javier, Tobar Carlos
Clínica Alemana de Santiago (Dr. Lara and Dr. Besomi); Hospital Padre Hurtado (Dr. Villegas and Dr. Tobar); and Clínica Avansalud (Dr. Tobar, Santiago, Chile).
J Am Acad Orthop Surg Glob Res Rev. 2017 Dec 26;1(9):e061. doi: 10.5435/JAAOSGlobal-D-17-00061. eCollection 2017 Dec.
To present a modification in the technique of an anterior approach for Bernese periacetabular osteotomy through an oblique inguinal incision.
Reorientation of the acetabulum in Bernese periacetabular osteotomy provides adequate coverage of the femoral head, improving biomechanical conditions of the joint without the risk of osteonecrosis. The principal author modified this procedure through an anterior approach with no detachment of the rectus femoris, allowing early rehabilitation. Evolution of scars is an issue both in the original technique and in our modification in terms of hypertrophy, depression, or hyperpigmentation and dehiscence. We introduce an oblique inguinal incision reducing both static and dynamic tension of the skin, allowing healing and avoiding development of unsatisfactory scars.
Thirty-five surgeries with a modified technique were performed in 27 patients between 2014 and 2016. The average patient age was 27.09 years. No patients were excluded. Development of hypertrophic, depressed, and hyperpigmented scars was evaluated in addition to dehiscence.
The average length of the scar was 14.1 cm, and average diastasis was 1.3 mm. There were no hypertrophic, depressed, or hyperpigmented scars. No patients had dehiscence or resutures of surgical wounds.
Oblique inguinal incision for the anterior approach in Bernese periacetabular osteotomy is a technique that allows healing of surgical wounds without dehiscence or hypertrophic changes by respecting tension lines. It has a high rate of patient satisfaction, with no complications.
介绍一种通过斜行腹股沟切口对伯尔尼髋臼周围截骨术前路技术进行的改良。
伯尔尼髋臼周围截骨术中髋臼的重新定向可提供股骨头的充分覆盖，改善关节的生物力学状况且无骨坏死风险。主要作者通过不切断股直肌的前路方法对该手术进行了改良，从而实现早期康复。无论是原始技术还是我们的改良技术，瘢痕的演变在肥大、凹陷、色素沉着或裂开方面都是一个问题。我们引入一种斜行腹股沟切口，可降低皮肤的静态和动态张力，促进愈合并避免出现不理想的瘢痕。
2014年至2016年间，对27例患者进行了35例采用改良技术的手术。患者平均年龄为２７.０９岁。无患者被排除。除了切口裂开外，还评估了肥厚性、凹陷性和色素沉着性瘢痕的发生情况。
瘢痕平均长度为14.1厘米，平均裂开为1.3毫米。无肥厚性、凹陷性或色素沉着性瘢痕。无患者出现手术切口裂开或再次缝合。
伯尔尼髋臼周围截骨术前路采用斜行腹股沟切口是一种通过遵循张力线实现手术切口愈合且无裂开或肥厚性改变的技术。患者满意度高，无并发症。
