The Bernese Periacetabular Osteotomy
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Martin Weber, Reinhold Ganz I
- چاپ و سال / کشور: 2002
Description
Objective A dysplastic acetabulum inadequately covering the femoral head is freed from the bony pelvis through several osteotomy cuts close to the joint, properly positioned and fixed with three screws. Indications Symptomatic acetabular dysplasia with closed physes. Osteoarthritis T6nnis stage _< 2. Improved coverage on abduction view. Contraindications Dislocation. Neoacetabulum. Worsening of congruence in abduction. Osteoarthritis TSnnis stage 3. Surgical Technique Modified Srnith-Petersen approach. Incomplete osteotomy of the ischial ramus. Complete osteotorny of the pubic rarnus. Supra- and retroacetabular osteotomies: perpendicular osteotomy directly below the anterosuperior iliac spine ending short of the linea terrninalis, continuing in direction of the ischial spine. Osteotomy 4 crn below the linea terminalis, connecting to the ischial osteotorny. Mobilization and reorientation. Radiographic control. Anterior capsulotomy: check for labral and chondral pathology, and impingement. Fixation with three 3.5-rnrn cortical screws. Reconstruction of the detached structures. No cast or orthosis. Touch weight bearing for 8 weeks, then abductor strengthening. Results Of the first 63 patients, 60 (71 hips) were followed for Io-14 years. 58 hipjoints were still preserved (82%), and function was excellent to good in 52 (73%). Negative prognostic factors were advanced age, osteoarthritis, and insufficient correction°
Orthopedics and Traumatology
