Le osteotomie periacetabolari e prossimali del femore

Abstract

Dysplasia of the hip is not an uniform anterolateral insufficiency of coverage of the femoral head but shows a multitude of pure and combined anterior, lateral, and posterior dysplasia. Overload of the rim generates pressure point loading which leads to rapid degenerative arthritis. The periacetabular osteotomy is a very powerful technique, offering the ability to correct deformity in all planes. However, just like any surgical technique, the indications and limitations of the technique must be understood. Osteotomies of the proximal femur for hip joint conditions are normally done at the intertrochanteric or subtrochanteric level. Intraarticular osteotomies would be more direct and therefore allow a more powerful correction with no o very little undesired side correction. Based on detailed knowledge of the vascular anatomy of the proximal femur, an approach to safely dislocate the femoral head, the extended retinacular soft tissue flap preparation and femoral neck osteotomy is described.