Extended Retinacular Soft-Tissue Flap for Intra-articular Hip Surgery:Surgical Technique,Indications,and Results of Application
Osteotomies of the proximal femur for hip joint conditions are normally done at the in-tertrochanteric or subtrochanteric level.Intra-articular osteotomies would be more direct and therefore allow a more powerful correction with no or very little undesired side cor-rection.However concerns about the risk of vascular damage and osteonecrosis of thefemo-ral head have so far basically excluded this technique from practical use.Based on detailed knowledge of the vascular anatomy of the proximal femur,an approach to safely dislocate the femoral head has been described and successfully performed.Experience as well asfur-ther studies of femoral head perfusion allowed a substantial extension of this approach,with subperiosteal exposure of the circumference of the femoral neck with constant intraopera-tive control of the blood supply to the head.Using the extended retinacular soft-tissueflap,four surgical techniques(relative neck lengthening,subcapital realignment in slipped capi-tal femoral epiphysis,true femoral neck osteotomy,and femoral head reduction osteotomy)evolved or became safer with respect to perfusion of the femoral head.The extended reti-nacular soft-tissue flap offers the technical and biologic possibility for a new class of intra-articular procedures.Although meticulous execution of the surgical steps is important,the procedures have a high level of safety for femoral head perfusion.
Reinhold Ganz Thomas W.Huf Michael Leunig
国内会议
北京
英文
68-82
2018-10-25（万方平台首次上网日期，不代表论文的发表时间）