Lazennec J Y, Mora Valladares N, Laudet C G, Barabas D, Ramare S, Hansen S, Guerin-Surville H, Saillant G
Service d'Anatomie, Faculté Pitié-Salpêtrière, Paris, France.
Surg Radiol Anat. 1998;20(3):153-9.
Pelvic osteotomies were developed to increase or restructure the acetabular surface. Periacetabular osteotomies are considered the most difficult from the technical point of view and necessitate sufficient residual cartilaginous surface. Juxta-acetabular osteotomies avoid major disorganization of the pelvic framework and allow easier reorientation of the acetabulum. The authors present a technical variant that preserves the entire posterior column, as in the Ganz osteotomy. The effects on the vascularisation of the periacetabular region are strictly the same and there is no necrosis of the subchondral bone. This osteotomy is easier to perform, because of a single positioning associating two simultaneous approaches. The osteotomies are rectilinear and easy to check peroperatively by fluoroscopy thanks to this positioning. Another valuable aspect of this double approach consists of very easy correction of "automatic" unwanted retroversion due to the lowering of the acetabular roof. This unintended displacement is rarely reported in the literature, despite its anatomic evidence in 3-dimensional CT-scan reconstructions for pre- and peroperative evaluation.
骨盆截骨术旨在增加或重塑髋臼表面。从技术角度来看，髋臼周围截骨术被认为是最困难的，并且需要足够的残余软骨表面。髋臼旁截骨术可避免骨盆框架的严重紊乱，并使髋臼更容易重新定位。作者提出了一种技术变体，如同在甘茨截骨术中那样保留整个后柱。对髋臼周围区域血管化的影响完全相同，且软骨下骨无坏死。由于单一定位结合了两种同步入路，这种截骨术更容易实施。由于这种定位，截骨线是直线的，并且在术中通过透视很容易检查。这种双入路的另一个有价值的方面是，由于髋臼顶下降导致的“自动”不必要的后倾很容易得到纠正。尽管在术前和术中评估的三维CT扫描重建中有解剖学证据，但这种意外移位在文献中很少被报道。
