Modifizierte Salter-Innominatum-Osteotomie für Erwachsene

Heimkes, B.; Schmidutz, F.; Roesner, J.; Frimberger, V. und Weber, P. (2018): Modifizierte Salter-Innominatum-Osteotomie für Erwachsene. In: Operative Orthopädie und Traumatologie, Bd. 30, Nr. 6: S. 457-468

Abstract

Objective. The dysplastic acetabulum is shifted three-dimensionally outwards and forwards. Indications. Symptomatic residual hip dysplasias and hip subluxations in skeletally mature patients up to the age of 50 years. Sharp's acetabular up to 60 degrees, as an exception above 60 degrees. Contraindications. Acetabular retroversion. Radiographic joint space at the lateral acetabular edge that is less than half the normal thickness for the patient's age. Relative contraindication: Elongated leg on the affected side. Surgical technique. Ilioinguinal approach in asupine position. Division of the innominate bone. Pivoting the distal osteotomy fragment outwards and forwards with the aid of the Salter maneuver. Fixing the fragments with aguide wire. Final correction of the osteotomy fragments. Force fitting of adovetail grooved, wedge-shaped bone graft. Insertion of acannulated compression screw and two further threaded rods. Wound closure. Postoperative management. Unloaded 3-point walking for 4 weeks. Increasing weight bearing from week 4. Full weight bearing from week 10-12. Results. Atotal of 45 consecutive patients (7 men, 38 women, 49 hips) underwent surgery. Average age at surgery was 27.6 years. The Sharp acetabular angle improved from preoperatively 45.7 degrees +/- 4.2 degrees by 13.8 degrees to 32.0 degrees +/- 6.4 degrees;the Wiberg (LCE) angle increased from 15.4 degrees +/- 9.3 degrees by 19.5 degrees to 34.9 degrees +/- 10 degrees postoperatively. The anterior center edge (ACE) angle increased from 28.9 degrees +/- 10.4 degrees by 8.6 degrees +/- 2.3 degrees to 37.5 degrees +/- 8.1 degrees. Complications requiring surgical intervention occurred in 7 patients.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0934-6694
• Sprache: Deutsch