[Five years experience with triple osteotomy of the pelvis, as described by steel.].
The authors present their five-year experience with triple osteotomy of the pelvis, as described by Steele, in a group of 31 patients and 35 operated hip joints. The mean age of the patients was 20 years, the mean follow up period 28 months (4 - 55). Prerequisites of surgery according to the authors are: 1. congruence of the head of the femur and aceta bulum, spherical or aspherical, before operation; 2. the possibility to achieve spherical or aspherical congruence by surgery; 3. sufficient functional range of movements in the hip joint, in particular inner rotation. The subjective satisfaction of patients with surgery was 79%, objective evaluation according to Harris revealed slight improvement on average from 64 to 76 points from a total of 91 attainable points. The operation does not significantly restrict movement in the hip joint. The mean gain of Sharp's angle was 15 , Wiberg's angle 23 and the AHI index 24%. As to complications, in 60% a pseudoarthrosis of the lower arm of the ischium developed with no impact on subjective or clinical results; a deep infection in one patient led to poor results as a result of severe insufficiency of the pelvifemoral muscles; discission of the femoral vein was treated at operation by suture without serious sequelae. The subjective and clinical results can be adversely influenced by the development of insufficieny of the pelvifemoral muscles due to incorrect reinsection to the blade of the ilium. Triple osteotomy of the pelvis should be performed only by experienced surgeons. However, if the technique is mastered it offers a very good opportunity to resolve insufficiency of the tectum of the head of the femur, possibly in combination with operations of the fe-mur/varisation osteotomy or distalisation of the greater trochanter in a single stage or valgisation distraction osteotomy in two stages. Key words: triple osteotomy of the pelvis according to Steel, osteotomy of the proximal femur.
Foldyna
K
K
Ortopedie Mestské nemocnice, Ostrava-Fifejdy.
Musialek
J
J
Boglevský
R
R