Dilogo Ismail Hadisoebroto, Fiolin Jessica, Pangestu Juniarto Jaya, Muhyi Amri
Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General National Hospital, Jl. Diponegoro No. 71, Jakarta Pusat, Indonesia.
Ann Med Surg (Lond). 2020 May 3;54:97-100. doi: 10.1016/j.amsu.2020.04.021. eCollection 2020 Jun.
Recurrent hip dislocation in a Down Syndrome patient with dysplastic hip is a very rare and challenging case to treat even for an expert orthopaedic hip surgeon. Least compliant patient and family, lowly educated with low socioeconomic status, young age and several anatomical variations forces limited option as a treatment. Several literatures mentioned Despite requiring only minimal implant, this technically demanding surgery requires a thorough understanding of the hip anatomy. This is the first case worldwide reporting 5 year follow up of dysplastic hip with DS treated successfully with periacetabular osteotomy (PAO) technique. An eighteen years old female with DS had multiple posterior hip dislocation episodes since 3 years prior our hospital admission. A modified Ganz PAO was performed under image intensifier guide. Patient was able to talk and hip was never dislocated again within 5 years follow up. Ganz periacetabular osteotomy, although a technically demanding surgery, is a preferable treatment in recurrent hip dislocation for Down Syndrome patient with good to excellent clinical and radiological outcome.
对于患有髋关节发育不良的唐氏综合征患者,复发性髋关节脱位是一种极为罕见且具有挑战性的病例,即使对于经验丰富的骨科髋关节外科医生来说也是如此。患者及其家属配合度极低,教育程度低,社会经济地位低下,年龄小以及存在多种解剖变异,使得治疗选择受限。多篇文献提到,尽管该手术仅需少量植入物,但这项技术要求很高的手术需要对髋关节解剖结构有透彻的了解。这是世界上首例报告采用髋臼周围截骨术(PAO)技术成功治疗唐氏综合征髋关节发育不良并进行5年随访的病例。一名18岁的唐氏综合征女性自入院前3年起出现多次髋关节后脱位。在影像增强器引导下进行了改良的甘茨PAO手术。患者能够交流,且在5年随访期间髋关节再也没有脱位。甘茨髋臼周围截骨术虽然是一项技术要求很高的手术,但对于唐氏综合征复发性髋关节脱位患者而言,却是一种较好的治疗方法,临床和影像学结果良好至极佳。