Perlik P C, Westin G W, Marafioti R L
J Bone Joint Surg Am. 1985 Jul;67(6):842-50.
Several surgical procedures have been devised to increase acetabular coverage of the femoral head in children with dysplasia of the hip. In this report we describe an acetabuloplasty that combines the key aspects of the Pemberton and Salter osteotomies. It has been used at the Los Angeles Unit of the Shriners Hospital for Crippled Children since the late 1960's. To assess the results of this combination procedure, fifty hips in forty-four children were evaluated at an average of six years postoperatively. The average age at operation was 7.3 years, and 62 per cent of the patients had had prior surgery. Clinically, thirty-two hips in which there had been no or slight symptoms preoperatively remained unchanged, twelve that had had preoperative limitations improved, and six showed some deterioration in terms of slight loss of motion, mild pain, and a limp. Roentgenographically, acetabular dysplasia (as measured by the acetabular index and by the center-edge angle of Wiberg) improved in more than 90 per cent of the hips. The roentgenographic results were comparable with those obtained by innominate or pericapsular osteotomy. The combination osteotomy has the advantages of both the Pemberton procedure and the Salter operation and proved to be an excellent surgical procedure for older children whose acetabular development did not progress as well as was expected.
为增加髋关节发育不良患儿股骨头的髋臼覆盖，已设计了多种外科手术方法。在本报告中，我们描述了一种结合了潘伯顿截骨术和索尔特截骨术关键要素的髋臼成形术。自20世纪60年代末以来，该手术已在洛杉矶的施莱宁儿童医院使用。为评估这种联合手术方法的效果，我们对44名儿童的50个髋关节进行了评估，平均随访时间为术后6年。手术时的平均年龄为7.3岁，62%的患者曾接受过先前的手术。临床上，术前无或仅有轻微症状的32个髋关节情况未变，术前有活动受限的12个髋关节有所改善，6个髋关节在活动度轻微丧失、轻度疼痛和跛行方面出现了一些恶化。X线片显示，超过90%的髋关节髋臼发育不良（通过髋臼指数和维伯格中心边缘角测量）得到改善。X线片结果与通过无名骨或关节囊周围截骨术获得的结果相当。这种联合截骨术兼具潘伯顿手术和索尔特手术的优点，对于髋臼发育未达预期的大龄儿童来说，是一种出色的外科手术方法。
