Iliac crest dissection plus subtrochanteric anterior angulation 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. plus femoral trochanteric anterior angle osteotomy for the treatment of hip flexion contracture deformity. Treatment of diseases: congenital hip abduction contracture and pelvic tilt Indication plus femoral trochanter lower anterior angle osteotomy for: 1. Severe hip contracture deformity is above 40°, and simple sputum peeling can not achieve the purpose of release. 2. The hip joint collapsed at the upper end of the femur with a posterior angulation deformity. Contraindications Patients under the age of 14. Preoperative preparation 1, routine preoperative preparation. 2. Take the X-ray film of the lateral position of the hip joint, and select the appropriate internal fixation plate according to the X-ray film to design the osteotomy site. Surgical procedure Incision Take a modified Smith-Petersen incision. 2. soft tissue stripping Press the peeling step to remove muscles and other contractures such as gluteal muscle, tensor fascia and rectus femoris. 3. Reveal the upper end of the femur and the large trochanter The iliac crest and the lateral femoral muscle origin were cut off from the lower edge of the large trochanter, and the muscle and periosteum were cut longitudinally along the anterior or posterior edge of the muscle, and the femur was deformed at the upper end of the femur. Two periosteal strippers were inserted into the posterior side of the femoral shaft at the small trochanteric margin to protect the surrounding soft tissue from damage. 4. Osteotomy The truncated bone was made at the posterior horn, and the two bone ends were held by two bone holders, and the hip joints were fully angled and fixed with a six-hole steel plate. If the hip contracture is severe, a wedge-shaped bone can be removed at the posterior femoral deformity to shorten the affected limb and achieve the purpose of loosening and correcting the deformity. 5. Suture the wound Irrigation of the wound with isotonic saline, complete hemostasis, in addition to the unpeeled tissue is not sutured, the other tissue incision should be sutured, pay attention to eliminate the dead space, indwelling drainage tube or drainage strip.