Papavasiliou V A
Clin Orthop Relat Res. 1986 Jun(207):198-204.
Although arthroplasty is the operation of choice for older patients with severe coxarthritis, in younger patients late mechanical complications cause serious problems. Upper femoral osteotomy based on Pauwels' principles has shown good results in some cases, but if total hip arthroplasty is needed later, the interference with the medullary canal adds considerably to the operative difficulties. The surgical procedure of transferring the greater trochanter distally and laterally was performed on 19 osteoarthritic hips. The clinical results were promising, producing relief of rest pain and increased range of movement. On radiologic examination the joint space reappeared or increased, even in severe cases. These results encourage further investigation of the procedure, especially because the absence of interference with the shape of the medullary canal does not add to the difficulties of possible later joint arthroplasty.
尽管关节置换术是老年重度髋关节炎患者的首选手术，但在年轻患者中，晚期机械并发症会引发严重问题。基于 Pauwels 原则的股骨上段截骨术在某些病例中显示出良好效果，但如果后期需要进行全髋关节置换术，对髓腔的干扰会大大增加手术难度。对19例骨关节炎髋关节实施了大转子向远侧和外侧转移的手术。临床结果令人鼓舞，静息痛缓解，活动范围增加。影像学检查显示，即使在严重病例中，关节间隙也重新出现或增宽。这些结果促使对该手术进行进一步研究，特别是因为该手术不干扰髓腔形状，不会增加后期可能进行的关节置换术的难度。
