Salcedo Cánovas César, Martínez Ros Javier, Molina González José, García Paños Juan Pedro, Toledo García Sarah, Ros Nicolás María José
Pediatric Orthopedics Unit, Virgen de la Arrixaca University Hospital (CSUR-National Reference Center for Pediatric Orthopedics, ERN BOND-European Reference Network on Rare Bone Disorders), Pediatric Orthopedics and Bone Reconstruction Research Group, IMIB-Arrixaca (Murcian Institute of Biosanitary Research), 30120 Murcia, Spain.
Children (Basel). 2025 Oct 3;12(10):1330. doi: 10.3390/children12101330.
BACKGROUND/OBJECTIVES: The sequelae from conditions affecting the proximal femur may cause instability, pain, leg length discrepancies and abnormal gait. Treatment options include arthrodesis and total hip arthroplasty, but both alternatives have limitations in young patients with severe deformities. Pelvic support osteotomy constitutes a viable option in these cases. The present study analyses the effectiveness and safety of the procedure.
This was a retrospective observational study on patients with an unstable or stiff hip treated with a pelvic support osteotomy. Both the results obtained and the complications that occurred were subjected to a statistical analysis. In addition, a narrative literature review was carried out to elucidate the biomechanical rationale and the results of the technique.
This study included a total of 12 patients (8 male and 4 female) with a mean age of 13 years (range: 0-19). All cases were unilateral and the mean follow-up time was 6.9 years (range: 1-10). Preoperative leg length discrepancy was 8 cm (range: 5-10), and all patients presented with a marked Trendelenburg sign. The mean leg lengthening achieved was 8 cm (range: 8-10), following a mean external fixation time of 263 days (range: 180-360), which entails an external fixation index of 32.5 days per centimeter lengthened (range: 25-37). Mean leg length discrepancy fell to 0.9 cm (range: 0-3) and the Trendelenburg sign improved following treatment: it disappeared in three patients (25%), it became mild in seven (58%), and it improved to moderate in two (17%). Eight patients (66%) experienced some sort of complication over the course of treatment.
Pelvic support osteotomies, combined with femoral lengthening, are a safe and effective option for managing severely damaged hips in children and adolescents.
背景/目的：影响股骨近端的疾病后遗症可能导致不稳定、疼痛、腿长差异和异常步态。治疗选择包括关节融合术和全髋关节置换术，但这两种方法在患有严重畸形的年轻患者中都有局限性。骨盆支撑截骨术是这些病例中的一种可行选择。本研究分析了该手术的有效性和安全性。
这是一项对接受骨盆支撑截骨术治疗的髋关节不稳定或僵硬患者的回顾性观察研究。对所获得的结果和发生的并发症进行了统计分析。此外，还进行了叙述性文献综述，以阐明该技术的生物力学原理和结果。
本研究共纳入12例患者（8例男性和4例女性），平均年龄13岁（范围：0至19岁）。所有病例均为单侧，平均随访时间为6.9年（范围：1至10年）。术前腿长差异为8厘米（范围：5至10厘米），所有患者均有明显的臀中肌步态。平均延长腿长为8厘米（范围：8至10厘米），平均外固定时间为263天（范围：180至360天），这意味着每延长1厘米的外固定指数为32.5天（范围：25至37天）。平均腿长差异降至0.9厘米（范围：0至3厘米），治疗后臀中肌步态得到改善：3例患者（25%）消失，7例（58%）变为轻度，2例（17%）改善为中度。8例患者（66%）在治疗过程中出现了某种并发症。
骨盆支撑截骨术联合股骨延长术是治疗儿童和青少年严重受损髋关节的一种安全有效的选择。
