Correction of a malunited vertical shear fracture : Staged sliding osteotomy of the pelvic ring.
The authors describe a posterior and anterior osteotomy of the pelvis for correction of a posttraumatic deformity in a 22-year-old female patient. As a shortening of the leg of 4 cm had occurred, surgery was performed in 2 stages. Between these 2 operations skeletal traction was employed. Main indications for this type of surgery included shortening of the leg, gait difficulties and poor posture while sitting. However, poor general health is considered to be a contraindication for such a risky surgery. During the surgical procedure all soft tissues preventing an proper correction have to be dissected or detached, particularly the sacrospinal and sacrotuberal ligaments. Screw fixation guarantees the correction. Exercises can be started as soon as the fragments become stable. Injuries to vessels and nerves are the most frequently encountered complications.The patient was symptom-free after 1 year postoperatively, mobility of both hips and her gait were normal. The author could observe a complete remodelling of the osteotomies after 1 year.
Baddoura
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O
Division of Orthopaedic Surgery, American University Hospital, P. O. Box 113-6044, Beirut, Lebanon.
Lakkis
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S
Taha
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A