Die Dreifach-Osteotomie des Beckens bei dysplastischen Hüftpfannen im Kindes- und Erwachsenenalter

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Abstract
We report on a post operative radiological and clinical follow-up (3-6.4 years) of 80 triple-osteotomies (29 operations according to the technique of Carlioz and 51 according to Tönnis). This study includes 32 osteotomies in children and 48 in adults. In 82% of the cases of low dysplastic hip joints and in 88% of the cases in severe dysplastic hip joints, the results came up to the expectations of the patients. The acetabular inclination angle and the acetabular angle improved about 10 degrees and the center edge angle about 25 degrees. In cases of neurological diseases, the radiological results of the hips were less satisfactory. The results is negatively influenced by pseudarthrosis and stress fractures in the ischium. These complications occur to a lower degree after Tönnis-osteotomy. From the age of 7, the triple-osteotomy represents an useful alternative to the operative correction of the hip joint dysplasia. The operation can be carried out in cases of congruity of head and acetabulum. Under certain circumstances, a transposition operation is additionally necessary, it is only indicated with a coxa valga. The triple-osteotomy can positively influence the biomechanical situation of the hip joint by means of an improved head roofing, by an ameliorated adjoining of the area of force reception to the pressure resultant and by medialisation of the acetabulum.

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