Tönnis D
Z Orthop Ihre Grenzgeb. 1978 Feb;116(1):130-2.
Operative reductions of congenital hip dislocation are sometimes difficult when lateral incisions are used since the medial part of the acetabulum and the lower limbus are difficult to visualize. In the Ludloff technique this part of the acetabulum is seen excellent, but not the lateral part. High dislocations with inverted limbus are difficult to reduce and only with partial excision of the limbus. An inguinal incision beginning lateral at the spina ilica ventralis offers the best view and can be used for all different degrees of dislocation and age groups. The technique is described, the advantages and the rate of avascular necrosis compared with other incisions. Femoral osteotomies and acetabular or pelvic osteotomies should not be done at the same time because of a higher percantage of avascular necrosis. In high dislocaitons shortening osteotomies should not be done in the intertrochanteric region but deeper in the shaft to avoid additional disturbances of the vascular system of the proximal femur.
当采用外侧切口时,先天性髋关节脱位的手术复位有时会很困难,因为髋臼内侧部分和下肢边缘难以可视化。在Ludloff技术中,髋臼的这一部分看得很清楚,但外侧部分则不然。伴有反向边缘的高位脱位很难复位,只有部分切除边缘才能复位。从腹侧髂棘外侧开始的腹股沟切口提供了最佳视野,可用于所有不同程度的脱位和年龄组。描述了该技术、与其他切口相比的优点以及无血管坏死率。由于无血管坏死的百分比更高,不应同时进行股骨截骨术和髋臼或骨盆截骨术。在高位脱位中,不应在转子间区域进行缩短截骨术,而应在股骨干更深的部位进行,以避免对股骨近端血管系统造成额外干扰。