Adduction osteotomy combined with contralateral acetabular capping

Normally, the pelvis remains horizontal, and the pelvis is tilted only when the gluteal muscle is paralyzed or the side of the leg is short. The iliac crest and hip abductor contracture can also cause pelvic tilt. Generally, the light pelvis is inclined, and the horizontal line of the highest point of the two ridges is 3 to 4 cm; the medium pelvis is inclined, and the horizontal lines of the two rafts are 5 to 6 cm or more apart. According to the light, medium and heavy clinical treatments, the different treatment methods are adopted: the light type is only the hip abduction deformity caused by the contracture of the hip, and the walking is obvious when walking. The early cutting of the bundle can be corrected. The mid-type hip abduction contracture deformity pelvic tilt is obvious, although the iliac crest cut can not be completely corrected, the upper end of the femur wedge-shaped adduction osteotomy. If there is hip dislocation on the contralateral side, hip capping is required. In addition to one side hip abduction deformity, the contralateral hip joint also has subluxation and short limb deformity, and the affected limb cannot touch the ground. Therefore, in addition to correcting hip dislocation and correcting short limb deformity, the contralateral balance is corrected, and the short limbs are corrected. The pelvis can basically reach symmetry to restore the balance of the lever, which is beneficial to improve the weight-bearing function of the lower limb. On the dislocation side, the short limbs are severe, and the tibia and femur are extended at the same time, or the acetabular cap is covered with the trochanter for osteotomy and bone graft extension. Treatment of diseases: dislocation of the hip Indication 1. The middle pelvis is tilted, and the pelvic tilt correction is unsatisfactory after the abduction contraction side iliac crest is cut, and the contralateral side has hip dislocation. For patients with contralateral hip dislocation, only adduction osteotomy was performed. 2. The adduction side has hip dislocation but the lower extremity is not obvious. Contraindications The abductor contraction side lower limb length or the adduction and dislocation side lower limb shortening is 5-6 cm or more. Surgical procedure 1. Adduction wedge osteotomy The lateral longitudinal incision of the hip joint was used to routinely expose the large trochanter and the upper end of the femur. A wedge-shaped osteotomy was performed on the lower edge of the small trochanter. After the wedge-shaped bone was removed, the lower extremity was adducted to make the longitudinal axis of the limb and The center line of the body is consistent, and the osteotomy line is fixed with a steel plate screw. 2. acetabular capping According to the conventional approach, after exposing the hip joint, an arcuate bone groove was made on the upper edge of the acetabulum, and a 4 cm×5 cm×1 cm humeral block was cut at the iliac crest to form an arc-shaped embedded in the bone groove. 3. Suture incision Insulate the incision with isotonic saline, completely stop bleeding, and suture the incision in layers.