Imhäuser G
Z Orthop Ihre Grenzgeb. 1977 Oct;115(5):716-25.
The author has reviewed the clinical and radiological results of 55 patients 11 to 22 years following an Imhäuser three dimensional intertrochanteric osteotomy for slipped capital femoral epiphysis. 13 additional patients responded by questionnaire. Of these 68 hips 66 were painfree and functional. One patient complained of pain (due to coxarthrosis proven by x-ray). A second patient was dissatisfied with the functional range of his hip. 40 of the 55 hips which were examined clinically and radiologically had full range of motion, 10 hips showed minimal and 5 hips significant limitation of motion. Radiologically 73% of the 55 hips examined were rated excellent or good, 27% showed beginning degenerative changes (including one patient with marked coxarthrosis). The results were greatly influenced by the severity and direction of slipping, preoperative treatment and the accuracy of operative correction. This study permits the conclusion that three dimensional intertrochanteric osteotomy prevented or at least delayed the development of degenerative changes in the majority of cases. It is possible that many of these patients will not develop coxarthrosis.
作者回顾了55例接受伊姆豪泽三维转子间截骨术治疗股骨头骨骺滑脱的患者在术后11至22年的临床和放射学结果。另外13例患者通过问卷调查作出回应。在这68个髋关节中,66个无痛且功能良好。1例患者抱怨疼痛(经X线证实为髋关节病)。另1例患者对其髋关节的功能范围不满意。在接受临床和放射学检查的55个髋关节中,40个活动范围正常,10个髋关节活动受限轻微,5个髋关节活动严重受限。放射学检查显示,在接受检查的55个髋关节中,73%被评为优秀或良好,27%显示有早期退变改变(包括1例有明显髋关节病的患者)。结果受滑脱的严重程度和方向、术前治疗以及手术矫正的准确性影响很大。这项研究可以得出结论,在大多数情况下,三维转子间截骨术可预防或至少延缓退变改变的发展。这些患者中的许多人有可能不会发展为髋关节病。