Ghaffari Arash, Kold Søren, Rahbek Ole
Interdisciplinary Orthopaedics, Aalborg University Hospital, Aalborg, Denmark.
J Child Orthop. 2020 Oct 1;14(5):379-386. doi: 10.1302/1863-2548.14.200163.
Double and triple femoral neck lengthening osteotomies have been described to correct coxa brevis deformity. Only small studies reported the results. Our aim was to provide an overview of the outcomes of double and triple femoral neck lengthening.
After an extensive search of different online databases, we included studies reporting the results of double and triple femoral neck osteotomies. Clinical and radiological outcomes, and reported complications were extracted. The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
After evaluating 456 articles, we included 11 articles reporting 149 osteotomies in 143 patients (31% male, 64% female, 5% unspecified). Mean age of the patients was 20 years (range 7 years to 52 years). Indications were developmental hip dysplasia (51%), Perthes disease (27%), infection (6%), post-trauma (4%), congenital disorders (2%), slipped capital femoral epiphysis (1%), idiopathic (3%) and unknown (6%). The mean limb length discrepancy reduced by 12 mm (0 mm to 40 mm). In total, 65% of 101 positive Trendelenburg sign hips experienced improvement of abductor muscle strength. An 18% (9% to 36%) increase could be found in functional hip scores. Mean increase in articulo-trochanteric distance was 24 mm (10 mm to 34 mm). Five patients older than 30 years at the time of osteotomy and two younger patients with prior hip incongruency had disappointing results and required arthroplasty. In all, 12 complications occurred in 128 osteotomies, in which complications were reported.
Double and triple femoral neck lengthening osteotomies in coxa brevis show good results with few complications in the literature, especially in young patients with non-arthritic hips.
III.
双股骨颈延长截骨术和三股骨颈延长截骨术已被描述用于矫正髋短缩畸形。仅有小型研究报道过其结果。我们的目的是对双股骨颈延长术和三股骨颈延长术的结果进行概述。
在广泛检索不同在线数据库后，我们纳入了报道双股骨颈截骨术和三股骨颈截骨术结果的研究。提取临床和放射学结果以及报道的并发症。审查过程按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行。
在评估456篇文章后，我们纳入了11篇文章，报道了143例患者的149例截骨术（男性31%，女性64%，5%未明确）。患者的平均年龄为20岁（范围7岁至52岁）。适应证包括发育性髋关节发育不良（51%）、佩特兹病（27%）、感染（6%）、创伤后（4%）、先天性疾病（2%）、股骨头骨骺滑脱（1%）、特发性（3%）和不明原因（6%）。肢体长度平均差异减少了12毫米（0毫米至40毫米）。在101例存在阳性特伦德伦伯格征的髋关节中，总共65%的患者外展肌力量得到改善。髋关节功能评分平均提高了18%（9%至36%）。关节转子间距离平均增加24毫米（10毫米至34毫米）。5例截骨时年龄大于30岁的患者和2例先前存在髋关节不匹配的年轻患者结果不理想，需要进行关节置换术。在所有报道有并发症的128例截骨术中，共发生了12例并发症。
文献中髋短缩的双股骨颈延长截骨术和三股骨颈延长截骨术显示出良好的效果，并发症较少，尤其是在非关节炎性髋关节的年轻患者中。
III级。
