Hedelin H, Larnert P, Hebelka H, Brisby H, Lagerstrand K, Laine T
Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Child Orthop. 2019 Jun 1;13(3):310-317. doi: 10.1302/1863-2548.13.180195.
The Salter innominate osteotomy (SIO) in children is traditionally stabilized by Kirschner-wires, which have issues regarding stability, infection and the need to be extracted. To counter these disadvantages, we present a surgical method to stabilize SIO with modern resorbable poly lactic-co-glycolic acid screws. Using a case series of 21 patients treated with SIO for developmental dysplasia of the hip or Legg-Calvé-Perthes disease we evaluate the feasibility of the method.
The integrity of the osteotomy was interpreted by radiological measurements of acetabular index, centre-edge angle and Reimer's index. Perioperative and postoperative complications were evaluated.
Radiographic evaluation revealed a stable osteotomy and favourable development in all measured parameters with the exception of one patient who fell out of bed the first day postoperatively. No other perioperative surgical complications were observed and there were no local reactions to the resorbable screws.
Modern resorbable screws carry multiple benefits both for the patient and the surgeon. In our case series the implants provided sufficient stability and the implants caused no local reactions. The use of resorbable implants gave the surgeon a wider range of possible screw placements and avoided the need for implant removal.
Level IV - Case series.
儿童Salter髋臼截骨术（SIO）传统上通过克氏针固定，克氏针存在稳定性、感染及需要取出等问题。为克服这些缺点，我们提出一种用现代可吸收聚乳酸-乙醇酸共聚物螺钉固定SIO的手术方法。通过对21例因发育性髋关节发育不良或Legg-Calvé-Perthes病接受SIO治疗的患者进行病例系列研究，我们评估了该方法的可行性。
通过测量髋臼指数、中心边缘角和赖默指数对截骨的完整性进行影像学评估。评估围手术期和术后并发症。
影像学评估显示，除1例患者术后第1天坠床外，所有测量参数的截骨均稳定且发育良好。未观察到其他围手术期手术并发症，对可吸收螺钉也无局部反应。
现代可吸收螺钉对患者和外科医生都有多种益处。在我们的病例系列中，植入物提供了足够的稳定性，且未引起局部反应。使用可吸收植入物使外科医生有更广泛的螺钉放置选择，并避免了植入物取出的需要。
IV级——病例系列。
