Lee D Y, Choi I H, Chung C Y, Cho T J, Lee J C
Department of Orthopaedic Surgery, Seoul National University Hospital and Children's Hospital, Chongno-gu, Republic of Korea.
J Bone Joint Surg Br. 1997 Mar;79(2):190-6. doi: 10.1302/0301-620x.79b2.7052.
We classified fixed pelvic obliquity in patients after poliomyelitis into two major types according to the level of the pelvis relative to the short leg. Each type was then divided into four subtypes according to the direction and severity of the scoliosis. In 46 patients with type-I deformity the pelvis was lower and in nine with type II it was higher on the short-leg side. Subtype-A deformity was a straight spine with a compensatory angulation at the lower lumbar level, mainly at L4-L5, subtype B was a mild scoliosis with the convexity to the short-leg side, subtype C was a mild scoliosis with the convexity opposite the short-leg side, and subtype D was a moderate to severe paralytic scoliosis with the convexity to the short-leg side in type I and to the opposite side in type II. A combination of surgical procedures improved the obliquity in most patients. These included lumbodorsal fasciotomy, abductor fasciotomy and stabilisation of the hip by triple innominate osteotomy with or without transiliac lengthening. In patients with type ID or type IID appropriate spinal fusion was usually necessary.
我们根据骨盆相对于短腿的高度，将小儿麻痹症患者的固定性骨盆倾斜分为两大类型。然后，根据脊柱侧弯的方向和严重程度，将每种类型再分为四个亚型。在46例I型畸形患者中，短腿侧的骨盆较低；在9例II型畸形患者中，短腿侧的骨盆较高。A型畸形是脊柱笔直，在下腰椎水平（主要是L4-L5）有代偿性成角；B型是轻度脊柱侧弯，凸向短腿侧；C型是轻度脊柱侧弯，凸向与短腿侧相反的一侧；D型在I型中是中度至重度麻痹性脊柱侧弯，凸向短腿侧，在II型中凸向相反一侧。联合手术方法改善了大多数患者的倾斜情况。这些手术包括腰背部筋膜切开术、外展肌筋膜切开术以及通过三联无名骨截骨术稳定髋关节，截骨术可伴或不伴经髂骨延长术。对于ID型或IID型患者，通常需要进行适当的脊柱融合术。
