adduction and internal rotation osteotomy

Where the hip joint is in a flexion position and cannot be straightened, it is called hip flexion contracture deformity. Mainly due to the effects of three factors such as hip flexor contracture and fascial ligament contracture shortening, abnormal posture and muscle imbalance. Hip flexion contracture can be divided into three types: 1 simple flexion contracture deformity; 2 flexion adduction and internal rotation deformity; 3 flexion abduction external rotation contracture deformity. The first two types of light only do sacral dissection; when the upper end of the femur has a posterior angulation deformity, only the soft tissue release can not achieve the purpose of treatment, the upper femoral anterior angle osteotomy should be performed; the flexion adduction and internal rotation deformity Patients with severe hip varus must also undergo abduction osteotomy, and flexion abduction external rotation contracture deformity should be treated with adduction and internal rotation osteotomy. Treatment of diseases: dislocation of the hip Indication Adduction and internal rotation osteotomy is suitable for hip flexion and abduction external rotation contracture deformity, and simple tendon peeling can not be corrected. Contraindications The age is under 14 years old. Preoperative preparation Preoperative hip X-ray examination, measuring the number of internal rotation, as a basis for intraoperative correction. Surgical procedure Incision Starting from the middle of the iliac crest, move forward along the iliac crest to the anterior superior iliac spine, then bend to the large trochanter and stop at the upper third of the femur. 2. Reveal the femur and osteotomy First, the iliac crest is removed, the contracted tendon is cut, the muscles of the large trochanter are detached upward, the gluteus maximus is cut open in the posterolateral aspect, and then the lateral femoral muscle is cut at the lower edge of the trochanter. The large and small trochanter and the upper end of the femur are exposed, and the femur is cut obliquely at the lower edge of the large and small trochanter, and the wedge-shaped bone with the bottom facing inward is removed, so that the distal end receives the internal rotation to correct the abduction external rotation deformity. The femoral head is opposite to the center of the acetabulum, and the humerus is facing forward to restore the normal axis. At the same time, after the hip joint is unrestricted, it is fixed with a steel plate screw. 3. Suture incision Irrigation of the wound with isotonic saline, complete hemostasis, suture the other tissues according to the level, and leave the drainage strip or drainage tube, except that the loosened tissue is not sutured.