Kouvalchouk J F, Balmary G, Rainaut J J
Nouv Presse Med. 1979 Mar 24;8(14):1147-51.
Study of 21 cases of femoral valgisation osteotomy, with a minimum follow-up of 5 years, confirms the value of this operation in the treatment of certain types of osteoarthrosis of the hip, and above all those types in which there is an inferior capital osteophyte. The indications depend upon: --clinical features: as in the case of all osteotomies, mobility must be at least equal to 70 degrees flexion. --radiological findings: reposition films in adduction should show widening of the joint space and above all improved congruence. The presence of geodes and lack of cover of the femoral head are not, in themselves, contraindications. The operation involves, in addition to valgisation inter-trochanteric osteotomy, relaxation of the peri-articular muscles (psoas, adductors, gluteus medius) in order that the relative lengthening of the upper end of the femur related to ventricalisation of the neck should not be in contradiction with the usual principles of surgery for osteoarthrosis. Valgisation osteotomy results in an increase in weight-bearing surfaces and thus a decrease in unit pressure. Indicated and performed in this way, this operation gives highly satisfactory and durable results, as shown by the follow-up period of our own cases.
对21例股骨外翻截骨术患者进行了研究,最短随访时间为5年,证实了该手术在治疗某些类型的髋关节骨关节炎中的价值,尤其是那些存在股骨头下骨赘的类型。手术指征取决于:——临床特征:与所有截骨术一样,活动度必须至少达到70度屈曲。——放射学表现:内收位复位片应显示关节间隙增宽,最重要的是关节吻合度改善。骨囊肿的存在以及股骨头覆盖不足本身并非手术禁忌证。该手术除了股骨转子间外翻截骨术外,还包括松解关节周围肌肉(腰大肌、内收肌、臀中肌),以便与股骨颈内翻相关的股骨上端相对延长不会与骨关节炎手术的常规原则相矛盾。外翻截骨术可增加负重面,从而降低单位压力。按照这种方式进行手术指征选择和操作,如我们自己病例的随访结果所示,该手术能带来非常令人满意且持久的效果。