Pontes Mariana DemÉtrio DE Sousa, Bortolin Paulo Henrique, Volpon JosÉ Batista
Universidade de São Paulo, Hospital das Clínicas, Ribeirão Preto Medical School, Department of Orthopedics and Anesthesiology, Ribeirão Preto, SP, Brazil.
Acta Ortop Bras. 2020 Nov-Dec;28(6):287-290. doi: 10.1590/1413-785220202806234170.
To evaluate the results of double femoral osteotomy for the treatment of severe sequelae of the hip.
Immature patients with anatomical loss of the hip were treated with pelvic support osteotomy in the distal femur to correct lower limb shortening, they were evaluated clinically and radiographically.
Eleven cases (eleven hips) were assessed with verage follow-up of three years. The mean age of the patients was 14.7 years. Seven patients had sequela of infectious arthritis; three had sequela of developmental dysplasia of the hip and one patient had a sequela of slipped capital femoral epiphysis. Preoperatively, the gluteus medius was insufficient in all patients, and it became negative in ten of them. The average of lower limb shortening was 5 cm (2.5 to 7 cm) and reduced shortening was 1.9 cm (0 to 4 cm). According to Paley Classification, 72.7% of complications were considered problems, 90.9% were considered obstacles and 27.2% complications, among which the limitation of the knee flexion was the most frequent.
The technique yielded good results, considering the severity of the sequela and the absence of a better therapeutic option. No important sequela was associated with the treatment.
评估双股骨截骨术治疗髋关节严重后遗症的效果。
对髋关节解剖结构缺失的未成熟患者采用股骨远端骨盆支撑截骨术治疗以纠正下肢短缩，对其进行临床和影像学评估。
评估了11例（11髋）患者，平均随访3年。患者平均年龄14.7岁。7例患者有感染性关节炎后遗症；3例有发育性髋关节发育不良后遗症，1例有股骨头骨骺滑脱后遗症。术前，所有患者臀中肌均不足，其中10例变为阴性。下肢平均短缩5cm（2.5至7cm），短缩减少量为1.9cm（0至4cm）。根据帕利分类，72.7%的并发症被认为是问题，90.9%被认为是障碍，27.2%为并发症，其中膝关节屈曲受限最为常见。
考虑到后遗症的严重程度以及缺乏更好的治疗选择，该技术取得了良好的效果。治疗未产生重要后遗症。
