Salter 骨盆截骨术的现代临床应用观点

发育性髋关节发育不良不仅仅是髋臼与股骨头对应关系的异常，同时还包括髋臼和股骨头的发育异常。为了克服行走期发育性髋关节发育不良儿童髋关节复位后仍然存在的髋关节不稳定，尤其是髋臼前外侧的发育缺陷， Robert Salter 于1961年发明了 Salter 骨盆截骨术（ salter innominate osteotomy，SIO ）治疗发育性髋关节发育不良。SIO 以耻骨联合为铰链，可使髋臼向前、下、外恢复覆盖，骨盆截骨处可通过骨块和克氏针固定，从而得到一个稳定复位的髋关节。1962年SIO还用于治疗Perthes病。SIO 至今已经沿用了50余年，治疗了大量的发育性髋关节发育不良病例，结合对于截骨应力、截骨方式的改良、植骨材料以及内固定等多方面的研究，SIO 在全世界多个医学中心获得了良好的短期和长期效果。

A review about the modern clinical application of Salter innominate osteotomy

Salter innominate osteotomy （ SIO ） has been performed in the treatment of developmental displasia of the hip （ DDH ） and Perthes disease for many years. It can restore the normal anatomy of the hip, adjust the biomechanical properties of the whole joint and promote the development of the hip by improving the geometrical relationship of the hip head. In order to better improve the hip function, some technical changes have been made in the angle of osteotomy, method of osteotomy and ifxation materials. SIO combined with proximal femoral osteotomy is a better choice for DDH and Perthes disease in the patients with different indications. The postoperative rehabilitation is a key problem. In order to achieve good long-term curative effects, much attention should be paid to the restoration of the joint range of motion, joint stress, neuromuscular control and control of the posture and gait. A review about SIO is presented as following.