Pelvic osteotomies for the treatment of hip dysplasia in children and young adults.
Pelvic osteotomies for the treatment of hip dysplasia in children and young adults.
复制标题
骨盆截骨术用于治疗儿童和年轻人的髋关节发育不良。
DOI：
10.5435/00124635-199909000-00005
复制
发表时间：
1999
期刊：
影响因子：
--
通讯作者：
D. Wenger
中科院分区：
文献类型：
--
作者：
B. Gillingham;Anthony A. Sanchez;D. Wenger
持续性髋臼发育不良是一个众所周知的原因过早髋关节骨关节炎。在发育不良的髋关节中，点载荷发生在陡峭、浅的髋臼边缘。骨盆截骨术通过增加接触面积、放松髋关节周围的关节囊和肌肉、改善髋关节的力臂和使承重力正常化来减少这种负荷。整形外科医生可以从各种骨盆截骨术中选择（例如，重定向、整形和挽救），以恢复髋关节上的正常解剖结构和生物力学力。残余发育不良的治疗是基于患者的年龄和是否存在一致的髋关节复位。Salter或Pemberton手术通常适用于2至10岁的儿童。对于年龄较大的儿童或青少年，如果三辐射状软骨仍然开放，可以考虑三无名截骨术。三辐射状闭合后，除了三无名截骨术外，还可以考虑Ganz髋臼周围截骨术。
Persistent acetabular dysplasia is a well-known cause of premature hip osteoarthritis. In the dysplastic hip, point loading occurs at the edge of the steep, shallow acetabulum. Pelvic osteotomies reduce this load by increasing the contact area, relaxing the capsule and muscles about the hip, improving the moment arm of the hip, and normalizing the forces of weight bearing. The orthopaedic surgeon can choose from among a variety of pelvic osteotomies (e.g., redirectional, reshaping, and salvage) for the purpose of restoring normal anatomy and biomechanical forces across the hip joint. Treatment of residual dysplasia is based on the patient's age and the presence or absence of congruent hip reduction. A Salter or Pemberton procedure is generally appropriate for a child between the ages of 2 and 10. A triple innominate osteotomy can be considered for the older child or adolescent in whom the triradiate cartilage remains open. After triradiate closure, the Ganz periacetabular osteotomy can be considered in addition to the triple innominate osteotomy.