Conception and Therapeutic Experience of Bombelli's Valgus-ExtensionOsteotomy.

Abstract

We should like to describe two points in this article. One thing is the biomechanics of an osteoarthritic hip that is related by Bombelli who makes use of Fischer's theory and Pawells' theory. The other is the therapeutic experience of Bombelli's valgus-extension osteotomy. We experienced ten cases in connection with the operation of Bombelli's valgus-extension osteotomy in Kitahyogo-Seikeigeka center. The object of this osteotomy is to reduce the pressure on the head of the fumer, to exploit the hydraulic mechanism, and to strech even more the superior zone of the joint capsule, the ligamentum teres and their synovial membrans. The roof osteophyte is formed by streching these tissues. The osteotomy is indicated in an osteoarthritis of the hio with a passive movement of about thirty degrees of flexion and fifteen degrees of adduction. The patient may walk with two crutches in seven days sfter operation, and to aboid full weight bearing for about six months. When he walks, he must set one foot directly in front of the other. We compared the function of the patients with that before the operations, when they discharged the hospital, at the mean time of sixteen weeks after the operation. It is recognized to reduce the activities of daily living for the reduced range of motion of the hip, and to delay the strengthening of gluteus medius and gluteus maximus. It is advisable to convince the patient to wait for six months or a year.