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The Ilizarov hip reconstruction osteotomy for hip dislocation: outcome after 4-7 years in 14 young patients 总被引:2,自引:0,他引:2
Treatment of neglected high dislocation of the hip is difficult in adults. We performed hip reconstruction osteotomy, consisting of a proximal abduction and extension osteotomy, and a distal varisation and lengthening osteotomy, utilizing the Ilizarov external fixator in 14 (12 women) patients having a mean age of 20 (12-33) years. The most frequent preoperative complaints were pain, leg-length discrepancy, limping, reduced activity and limited abduction of the hip. After an average follow-up of 68 (55-81) months, the outcome was satisfactory; pain subsided in all patients, the Trendelenburg sign became negative in all but 3 patients, no patient had limb-length discrepancy, and alignment of the extremity was reestablished. However, 3 patients still complained of lurch. 相似文献
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Salter截骨术与股骨近端旋转截骨治疗小儿发育性髋脱位 总被引:1,自引:0,他引:1
[目的]探讨应用Salter骨盆截骨与股骨近端旋转截骨术式治疗儿童发育性髋关节脱位。[方法]运用Salter截骨增加关节包容,截骨纠正股骨近端畸形。对16例26髋进行了联合手术。分析治疗结果。[结果]所有病例均在术后得到随访,按M ckay临床评价标准,优16髋,良6髋,中3髋,差1髋。[结论]该联合术式针对发育性髋脱位的病理,经骨盆及股骨近端截骨,获得稳定、功能良好的关节。 相似文献
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This article reports on the case of a twenty-eight-year-old woman who developed recurrent hip dislocation after open reduction and internal fixation of a posterior wall hip fracture-dislocation with an associated femoral head fracture. Because of the posterior wall deficiency, a modified periacetabular osteotomy was performed to stabilize the hip. At the two-year follow-up, there was no evidence of osteonecrosis in the remaining femoral head and the joint space was maintained. There has been no recurrence of dislocation. This procedure may be indicated in a patient with an unreconstructable posterior wall deficiency and persistent instability after a traumatic hip dislocation. 相似文献
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Total hip arthroplasty is problematical in the case of high dislocation. To reposition the hip, a femoral shortening osteotomy
is necessary in order to prevent damage to the neurovascular structures. This paper describes the implantation of a cementless
straight stem in 15 patients using a simple technique with a simultaneous, derotating and shortening osteotomy. Femur fractures,
pseudoarthroses, stem loosening, paresis and deep infections were not found. One socket loosening was revised. Fourteen patients
had good or very good results in the Merle d’Aubigne score after a median of 4.3 (range 2–5.6) years of follow-up. The surgical
technique described enables the initial stable fixation of a standard prosthesis without additional osteosynthesis. Additional
advantages include a shorter duration of surgery, a lower complication rate and a more rapid consolidation of the osteotomy.
Received: 8 March 1999 相似文献
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髋联合截骨术一次性重建关节结构治疗严重先天性髋关节脱位 总被引:2,自引:2,他引:0
目的 探讨髋联合截骨术一次性重建关节结构治疗严重先天性髋关节脱位的临床效果。方法 应用髋联合截骨术治疗严重先天性髋脱位患儿26例34髋并随访1~3年。结果 26例34髋中,24例32髋效果良好,髋关节功能恢复正常;合并股骨头坏死10例12髋中,治疗后11髋功能恢复正常。结论 髋联合截骨术是良好的一次性重建严重先天性髋关节脱位关节结构的方法,同时对并发股骨头坏死也有治疗效果。 相似文献
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We describe 95 patients with previously treated congenital dislocation of the hip who underwent femoral osteotomy after the age of five years. The commonest indication for surgery was progressive uncovering and subluxation of the femoral head; other reasons were coxa vara, long leg dysplasia and persistent anteversion. Femoral osteotomy for uncovering of the femoral head (Severin Grade III) in this age group gave good results at maturity only when the acetabular angle was less than 25 degrees before operation. Femoral osteotomy alone was inadequate for true subluxation of the hip (Severin Grade IV). 相似文献
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Dallari D Pignatti G Stagni C Giavaresi G Del Piccolo N Rani N Veronesi F Fini M 《Orthopedics》2011,34(8):e328-e333
We retrospectively evaluated the postoperative results of total hip arthroplasty (THA) in patients presenting with Crowe group IV dislocated hips. Overall, results were compared with regard to the type of osteotomy performed (Z or oblique) to define the correct indications for surgical technique and choice of prosthetic implant. Thirty-three subtrochanteric shortening and derotational osteotomies in primary THA were performed in 26 patients secondary to congenital hip dislocation. A Z osteotomy was performed in 14 cases and an oblique osteotomy in 19. The surgical approach was direct lateral, and surgery was aimed at restoring the anatomic hip center. Femoral and acetabular fixation was uncemented. The most used stem was the S-ROM (DePuy, Leeds, United Kingdom), and the couplings used were ceramic-ceramic (7 cases), ceramic-polyethylene (3 cases), metal-polyethylene (15 cases), and metal-metal (3 cases). Mean follow-up was 88±45 months. According to the Merle D'Aubigné score, the overall clinical results were good in 23 cases, satisfactory in 6, and fair in 4. Union of the osteotomy occurred in 97% of cases, and the mean time required for osteotomy union was 6±2 months without significant differences between Z and oblique osteotomies. At last follow-up, there was loosening of 1 cup and 1 stem, and revision was necessary. Twelve percent of patients experienced postoperative dislocation and 9% developed neuropraxia of the femoral nerve. The clinical and radiological results were similar in both groups, with a high rate of pain relief, an improvement in limb-length discrepancy, and reduced limping, leading to a smaller or no insole. Currently, the more complex Z osteotomy has been abandoned, because a modular stem prosthesis with metaphyseal sleeve allows the oblique osteotomy to be used with an easier and shorter surgical procedure. 相似文献
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Arthroplasty for congenital hip dislocation. Techniques for acetabular reconstruction 总被引:1,自引:0,他引:1
We investigated a series of 63 arthroplasties for chronically dislocated hips or severe dysplasia with at least two thirds of the femoral head uncovered. Direct cementation into the neoacetabulum at the pelvic wing was followed by 6/20 revision arthroplasties and 3/20 impending failures. Cups supported by cortical bone grafts were revised in 8/16 and found loose in 2/12 arthroplasties. The best technique was restoration of the rotational center of the hip joint and roof reconstruction with a femoral head graft with 2/25 revisions and signs of loosening in 2/25. 相似文献
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Marimuthu K Joshi N Sharma CS Bhargava R Meena DS Bansiwal RC Govindasamy R 《Archives of orthopaedic and trauma surgery》2011,131(12):1631-1637