Fahri Emre, Uluyardimci Enes, Tahta Mesut, Karaaslan Ahmet Adnan, Işik Çetin
VM Medicalpark Ankara Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.
Yildirim Beyazit University, Department of Orthopedics and Traumatology, Ankara, Turkey.
Acta Chir Orthop Traumatol Cech. 2025 Jul;92(3):153-159. doi: 10.55095/achot2025/008.
This study aimed to present the clinical and radiological results and look for complications of total hip arthroplasty (THA) performed with subtrochanteric transverse femoral shortening osteotomy (STFO) for Crowe type IV developmental dysplasia of the hip (DDH).
Ninety-four patients who underwent STFO and THA for Crowe type IV DDH between 2013 and 2018 were retrospectively evaluated. The mean follow-up period of the patients was 40 months (range 25 to 55) and the mean operation time was 58 min (range 52 to 70). We examined the results of routine anteroposterior and lateral hip radio- graphy. The time required for healing of the osteotomy line, preoperative and postoperative Harris Hip Score (HHS), limb length discrepancies, the level of limping and Trendelenburg tests were evaluated for all patients. All complications were noted.
The mean healing time was 5.4 months (range 4 to 10). The preoperative HHS improved from a mean of 52 points (range 42 to 61) to 84 points (range 75 to 96) after the operation (p < 0.001). Only two patients had postoperative positive Trendelenburg tests. There were no cases of nonunion or sciatic nerve palsy. An interoperative femoral fracture was observed in one case.
This study demonstrates that excellent clinical outcomes can be achieved with no revisions, no nonunion, and minimal residual limping in patients who undergo shortening with STFO using a Wagner cone for the femur and a primary cup for the acetabulum.
本研究旨在呈现采用转子下股骨横向缩短截骨术（STFO）治疗Crowe IV型发育性髋关节发育不良（DDH）的全髋关节置换术（THA）的临床和放射学结果，并寻找并发症。
回顾性评估了2013年至2018年间接受STFO和THA治疗Crowe IV型DDH的94例患者。患者的平均随访期为40个月（范围25至55个月），平均手术时间为58分钟（范围52至70分钟）。我们检查了常规的髋关节前后位和侧位X线片结果。评估了所有患者截骨线愈合所需时间、术前和术后Harris髋关节评分（HHS）、肢体长度差异、跛行程度和Trendelenburg试验。记录了所有并发症。
平均愈合时间为5.4个月（范围4至10个月）。术后HHS平均从术前的52分（范围42至61分）提高到84分（范围75至96分）（p < 0.001）。只有两名患者术后Trendelenburg试验呈阳性。没有出现骨不连或坐骨神经麻痹病例。术中观察到1例股骨骨折。
本研究表明，对于使用瓦格纳股骨假体和髋臼初次假体进行STFO缩短术的患者，可实现良好的临床效果，无需翻修、无骨不连且残留跛行最小。
