| 摘要 |
FIELD: medicine.SUBSTANCE: anterior approach to a wing of ilium is involved. A triangular bone graft with a base and sides not less than 1.5 cm on a muscular pedicle is cut out of a tailor's muscle. The graft with the muscular pedicle are displaced in the medial direction. An iliolumbar muscle is separated in the distal direction and dissected away within a tendon at a lesser trochanter. The muscle is displaced inward. The approach extends through a lateral portion of an external obturator muscle. An ischial bone is exposed at the wound depth and protected with elevators inward. The ischial bone is incised in the oblique direction anteroposteriorly with 2 parallel section from the medial side spaced 3-5 mm. A posterior portion of the ischial bone is cracked at the wound depth with using fulcrum motions of the flat chisel. A periosteom is incised above a pubic bone and transected with the flat chisel at the base under the protection of the elevators. The iliac bone is transected in a supra-acetabular portion of the pelvis either crosswise, or semicircularly using a Gigli saw or a flat chisel directly above an anterior inferior spine of an iliac bone. A mobilised acetabular fragment is rotated onto a femoral head until covered completely, a trochanteric portion of the femur is pressed to medialise a hip joint. The cut-out bone graft on the muscular pedicle is placed in an anteroexterior portion of the iliac bone in a cleft between the fragments. The pelvic fragments and graft are fixed with K wires downright from an anterior superior spine.EFFECT: recovering the anatomic relations in the hip joint, reducing the technical difficulties of the acetabular transposition, increasing the stability of the fragment fixation following the pelvis osteotomy, and improving the trophism within a contact zone of the pelvic bone fragments.3 ex |
