亜脱臼障害に對する髀臼蓋成形術

抄録

“Congenital subluxation of hip” in this study means disposition of dislocation, kysplasia or hypoplasia of acetabulum, or developmental malformation after manipulative reduction. This condition may often develop pain, limb or abnormal fatigue by 12 to 13 years of age. For the relief of these symptoms, various operations may be performed, and one of them is Schelf Operation. There have been many papers which reported that this operation will result functional stability and reduce symptoms.
The authors performed the operation in 12 cases, in 14 joints, and have checked the effects of the operation. The follow up period were 1 year to 3 years. The results were classified into “very good”, “good”, and “fair” or “improved”.
Two joints were “very good”, 5 joints, “good”, 4 joints, “fair” and the other 3 joints, “improved”. The followings are our conclusions;
1) In case of Schelf operation, strong traction for several days before operation, placing of caput femoralis as far down as possible at the time of operation and building of the Schelf as large enough to cover the caput femoralis without abduction by adutting against trochanter are important. Graft must be large, stable, not to be absorbed.
2) Indications of the operation are those which satisfy the following conditions;
a) Caput femoralis is tracted as far downwards as possible.
b) “CE angle” is at least from slightly positive or minus.
c) Epiphyseal line of the head of femur is closed.
.d) Arthritic symptoms are not present remarkably. Anterior version of the neck of femur or torsion of the shaft are not present.