BACKGROUND & AIMS: PURPOSE:The goal of this study was to document the outcome at midterm follow-up of 19 patients treated for lateral osteoarthritis of the knee between 1999 and 2007. It was our hypothesis that the results and complication rate would be comparable to or better than those reported in the literature for closing wedge or alternative open wedge techniques. METHODS:All patients underwent an open wedge distal femoral varisation osteotomy using the Puddu plate system combined with calcium phosphate injection into the defect. Knee Society Knee Score and Kellgren-Lawrence osteoarthritis score were assessed preoperatively and at final follow-up. RESULTS:The average knee score improved significantly from 43 ± 8 preoperatively to 78 ± 23 at final follow-up. The Kellgren-Lawrence osteoarthritis score remained unchanged. Kaplan-Meier analysis using revision surgery or conversion to TKA as an endpoint demonstrated an 82% successful survivorship at 7 years of follow-up. CONCLUSION:Based upon these results, we believe that a distal femoral varisation osteotomy using the Puddu plate and injectable bone cement is an equivalent treatment option compared to closing wedge techniques and leading to good results at midterm follow-up in patients with lateral gonarthrosis and valgus alignment. LEVEL OF EVIDENCE:IV.

背景与目标： 目的：本研究的目的是记录1999年至2007年间接受治疗的19例膝关节外侧骨关节炎患者的中期随访结果。我们的假设是，其结果和并发症发生率可与之相比或更高。在文献中报道了封闭楔形或其他开放楔形技术。
方法：所有患者均采用Puddu钢板系统结合磷酸钙注射入缺损处，进行楔形远端股骨远端静脉切开截骨术。膝关节协会术前和最终随访时评估了膝关节评分和Kellgren-Lawrence骨关节炎评分。
结果：平均膝关节评分从术前的43±8显着提高到最终随访时的78±23。 Kellgren-Lawrence骨关节炎评分保持不变。 Kaplan-Meier分析（以翻修手术或转为TKA为终点）显示，在7年的随访中成功存活率达82％。
结论：基于这些结果，我们认为与闭合楔形技术相比，使用Puddu钢板和可注射骨水泥进行股骨远端远端截骨术是同等的治疗选择，并能在外侧膝关节病和外翻患者的中期随访中取得良好的效果结盟。
证据级别：IV。

BACKGROUND & AIMS: :We developed a new internal fixator: a rigid T: -shaped plate with locking screws and wedge-shaped spacer block for high tibial osteotomy. The purpose of the present study was to evaluate the radiographic outcome of opening-wedge high tibial osteotomy (OWHTO) using this new internal fixator. Sixty OWHTOs were performed in patients with medial compartment osteoarthritis and varus deformity (28 males and 23 females). Patients' mean age was 60.4 years. Preoperative and postoperative radiographs were obtained. The paired t-test was used to evaluate the differences over time with respect to radiographic variables. Union of the osteotomy gap was obtained in all patients, and no implant breakage was found. On anterior-posterior radiographs, a significant difference was observed (p < 0.01) between the preoperative and postoperative mean values of femorotibial angles (179.6 ± 3.2 vs. 170.6 ± 2.5 degrees), weight-bearing line ratios (23.8 ± 13.5 vs. 60.5 ± 11.5%), anatomical medial proximal tibial angles (84.8 ± 2.5 vs. 91.0 ± 2.6 degrees), and joint line coverage angles (3.6 ± 2.0 vs. 2.4 ± 1.7 degrees). On lateral radiographs, posterior tibial slopes were 11.5 ± 3.9 degrees preoperatively and 12.2 ± 4.0 degrees postoperatively (p < 0.01), and Insall-Salvati ratios were 1.04 ± 0.12 preoperatively and 1.06 ± 0.13 postoperatively (p = 0.24). Performing OWHTO using a new internal fixator with a wedge-shaped spacer achieves adequate correction of lower limb alignment without implant-related complications. This is a Level IV, case series study.

背景与目标： ：我们开发了一种新的内部固定器：带有锁定螺钉和楔形间隔块的刚性T型板，用于胫骨高度截骨术。本研究的目的是评估使用这种新型内固定器的楔形高位胫骨截骨术（OWHTO）的放射学结果。在患有内侧间隔性骨关节炎和内翻畸形的患者中进行了60次OWHTO（男性28例，女性23例）。患者的平均年龄为60.4岁。术前和术后摄片。配对t检验用于评估射线照相变量随时间的差异。所有患者均获得截骨间隙的联合，未发现植入物损坏。在前后X线片上，观察到股骨角的术前平均值与术前平均值（p <0.01）（179.6±3.2 vs. 170.6±2.5度），负重线比（23.8±13.5 vs. 60.5）之间存在显着差异（p <0.01）。 ±±11.5％），解剖学上内侧胫骨近角（84.8±±2.5 vs.91.0±±2.6°）和关节线覆盖角（3.6±2.0±2.4与2.4±1.7°）。在侧位片上，胫骨后倾斜度分别为术前11.5±3.9度和术后12.2±4.0度（p <0.01），Insall-Salvati比分别为术前1.04±0.12和术后1.06±0.13（p = 0.24）。使用带有楔形垫片的新型内部固定器进行OWHTO，可以充分矫正下肢的位置，而不会造成植入物相关的并发症。这是IV级案例研究。

BACKGROUND & AIMS: :Segmented filamentous bacteria (SFB) are present in the gastrointestinal tract of mice from weaning until the maturation of the immune system. Probiotic bacteria also have an effect on host immunity. To study the relationships established between these bacteria, samples from a mouse model fed with Lactobacillus plantarum under different immunological conditions were analysed. SFB populations were measured by a newly designed group-specific quantitative PCR assay. The results confirmed the presence of the probiotic in the intestine and an expansion of SFB in the ileum of immunocompromised mice, which was abolished upon administration of L. plantarum, an effect not described to date.

背景与目标： 从断奶到免疫系统成熟，小鼠胃肠道中均存在节段性丝状细菌（SFB）。益生菌也对宿主免疫力有影响。为了研究这些细菌之间的关系，分析了在不同免疫条件下饲喂植物乳杆菌的小鼠模型的样品。通过新设计的组特异性定量PCR测定法测量SFB种群。结果证实了肠道中存在益生菌，免疫受损小鼠的回肠中存在SFB的扩展，这在施用植物乳杆菌后就被取消了，迄今为止尚未描述这种作用。

BACKGROUND & AIMS: BACKGROUND:Current literature describing the periacetabular osteotomy (PAO) is mostly limited to retrospective case series. Larger, prospective cohort studies are needed to provide better clinical evidence regarding this procedure. The goals of the current study were to (1) report minimum 2-year patient-reported outcomes (pain, hip function, activity, overall health, and quality of life), (2) investigate preoperative clinical and disease characteristics as predictors of clinical outcomes, and (3) report the rate of early failures and reoperations in patients undergoing contemporary PAO surgery. METHODS:A large, prospective, multicenter cohort of PAO procedures was established, and outcomes at a minimum of 2 years were analyzed. A total of 391 hips were included for analysis (79% of the patients were female, and the average patient age was 25.4 years). Patient-reported outcomes, conversion to total hip replacement, reoperations, and major complications were documented. Variables with a p value of ≤0.10 in the univariate linear regressions were included in the multivariate linear regression. The backward stepwise selection method was used to determine the final risk factors of clinical outcomes. RESULTS:Clinical outcome analysis demonstrated major clinically important improvements in pain, function, quality of life, overall health, and activity level. Increasing age and a body mass index status of overweight or obese were predictive of improved results for certain outcome metrics. Male sex and mild acetabular dysplasia were predictive of lesser improvements in certain outcome measures. Three (0.8%) of the hips underwent early conversion to total hip arthroplasty, 12 (3%) required reoperation, and 26 (7%) experienced a major complication. CONCLUSIONS:This large, prospective cohort study demonstrated the clinical success of contemporary PAO surgery for the treatment of symptomatic acetabular dysplasia. Patient and disease characteristics demonstrated predictive value that should be considered in surgical decision-making. LEVEL OF EVIDENCE:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

背景与目标： 背景：目前描述髋臼周围截骨术（PAO）的文献大多局限于回顾性病例系列。需要进行更大范围的前瞻性队列研究，以提供有关该程序的更好的临床证据。当前研究的目标是（1）报告至少2年患者报告的结局（疼痛，髋关节功能，活动，总体健康状况和生活质量），（2）研究术前临床和疾病特征作为临床预测指标结果；（3）报告了接受当代PAO手术的患者早期失败和再次手术的比率。
方法：建立了一个大型，前瞻性，多中心的PAO程序队列，并分析了至少2年的结局。总共分析了391个髋关节（79％的患者为女性，平均患者年龄为25.4岁）。记录了患者报告的结局，全髋关节置换术，再次手术和主要并发症。单变量线性回归中p值≤0.10的变量包括在多元线性回归中。使用向后逐步选择方法确定临床结果的最终危险因素。
结果：临床结果分析表明，疼痛，功能，生活质量，整体健康状况和活动水平在临床上具有重要的临床意义。年龄增长和超重或肥胖的体重指数状态预示了某些结局指标的改善结果。男性和轻度髋臼发育不良可预示某些结局指标的改善较小。其中三名（0.8％）的髋关节接受了早期全髋关节置换术的转化，其中12例（3％）的患者需要再次手术，而26例（7％）的患者发生了严重并发症。
结论：这项大型的前瞻性队列研究证明了当代PAO手术治疗有症状的髋臼发育不良的临床成功。患者和疾病特征显示出预测价值，应在手术决策中予以考虑。
证据级别：治疗级别IV。有关证据级别的完整说明，请参见《作者说明》。

BACKGROUND & AIMS: PURPOSE:To report outcomes of patients with distal radius fracture malunions treated with corrective osteotomy and orthogonal volar and radial "90-90" plate fixation. METHODS:We performed a retrospective review of all patients who underwent distal radius corrective osteotomy and 90-90 fixation from January 2008 through December 2014. Demographic data, injury history, prior treatments, and clinical examination values were recorded. Preoperative radiographic measurements were used to classify the type and severity of deformity. The outcomes were patient-reported pain levels, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) functional scores, and radiographic outcomes. Secondary outcomes, including complications and the need for additional surgeries, were also noted. RESULTS:Thirty-nine cases (31 extra-articular, 8 combined intra- and extra-articular) were included. At mean postoperative follow-up interval of 4 years, significant improvements were observed clinically in wrist flexion-extension arc, grip strength, pain, and Quick Disabilities of the Arm, Shoulder, and Hand scores. Radiographically, significant postoperative improvements were noted in ulnar variance, radial inclination, intra-articular stepoff, and radial tilt, with volarly and dorsally angulated malunions corrected to 9° and 7° of volar tilt, respectively. Twelve patients (31%) underwent additional surgery, the most common being plate removal in 7 patients, 3 of which involved removal of the radial plate. CONCLUSIONS:For patients with symptomatic malunion of the distal radius, corrective osteotomy with 90-90 plate fixation is an effective treatment option for improving pain and restoring function for both volarly and dorsally angulated malunions, including malunions with an intra-articular component. TYPE OF STUDY/LEVEL OF EVIDENCE:Therapeutic IV.

背景与目标： 目的：报告采用矫正截骨术和正交掌和and骨“ 90-90”钢板固定治疗的distal骨远端骨折畸形畸形患者的预后。
方法：我们对从2008年1月至2014年12月进行了distal骨远端远端截骨术和90-90固定的所有患者进行了回顾性研究。记录了人口统计学数据，损伤史，既往治疗和临床检查值。术前影像学检查用于对畸形的类型和严重程度进行分类。结果是患者报告的疼痛程度，手臂，肩膀和手的快速残疾（QuickDASH）功能评分以及影像学结果。还注意到次要结果，包括并发症和需要额外手术的情况。
结果：共纳入39例（关节外31例，关节内外8例）。术后平均随访间隔为4年，临床上观察到腕部屈伸弧度，握力，疼痛以及手臂，肩部和手部快速残疾的得分有明显改善。影像学检查发现，尺侧方差，radial骨倾斜，关节内脱位和radial骨倾斜有明显的术后改善，手掌和背角畸形畸形分别矫正为掌侧倾斜9°和7°。 12例患者（占31％）接受了额外的手术，其中最常见的是7例患者中的钢板切除，其中3例涉及了radial骨钢板的切除。
结论：对于有症状的远端radius骨畸形患者，采用90-90钢板固定矫正截骨术是一种有效的治疗选择，可改善掌侧和背角畸形畸形，包括关节内畸形畸形的疼痛并恢复其功能。
研究类型/证据级别：治疗IV。

BACKGROUND & AIMS: AIMS:This study compared the long-term results following Salter osteotomy and Pemberton acetabuloplasty in children with developmental dysplasia of the hip (DDH). We assessed if there was a greater increase in pelvic height following the Salter osteotomy, and if this had a continued effect on pelvic tilt, lumbar curvature or functional outcomes. PATIENTS AND METHODS:We reviewed 42 children at more than ten years post-operatively following a unilateral Salter osteotomy or Pemberton acetabuloplasty. We measured the increase in pelvic height and the iliac crest tilt and sacral tilt at the most recent review and at an earlier review point in the first decade of follow-up. We measured the lumbar Cobb angle and the Short Form-36 (SF-36) and Harris hip scores were collected at the most recent review. RESULTS:During the first decade of follow-up, there was a greater increase in pelvic height in the children who had a Salter osteotomy (Salter, 10.1%; Pemberton, 4.3%, p < 0.001). The difference in the increase in pelvic height was insignificant at the most recent review (Salter, 4.4%; Pemberton, 3.1%, p = 0.249). There was no significant difference between the two groups for the lumbar Cobb angle, (Salter, 3.1°; Pemberton, 3.3°, p = 0.906). A coronal lumbar curve was seen in 41 children (97%), 30 of these had a compensatory curve. Sacral tilt was the radiographic parameter for pelvic imbalance that correlated most with the lumbar Cobb angle (Pearson correlation co-efficient 0.59). The Harris hip score and SF-36 were good and showed no differences between the two groups. CONCLUSION:In the long-term, we found no difference in the functional results or pelvic imbalance between Salter osteotomy and Pemberton acetabuloplasty in the management of children with DDH. Cite this article: Bone Joint J 2016;98-B:1145-50.

背景与目标： 目的：本研究比较了Salter截骨术和Pemberton髋臼成形术后小儿髋关节发育不良（DDH）的长期结果。我们评估了Salter截骨术后骨盆高度是否有更大的增加，以及这是否对骨盆倾斜，腰椎弯曲或功能预后有持续影响。
病人和方法：我们回顾了42例儿童在单侧Salter截骨术或彭伯顿髋臼成形术后十余年的情况。在最近的回顾中以及随访的第一个十年中，我们在较早的回顾点测量了骨盆高度和the倾斜度和tilt骨倾斜度的增加。我们测量了腰部Cobb角，并在最近的评论中收集了Short Form-36（SF-36）和Harris髋关节评分。
结果：在随访的第一个十年中，进行了Salter截骨术的儿童的骨盆高度有更大的增加（Salter，10.1％； Pemberton，4.3％，p <0.001）。在最近的评估中，骨盆高度增加的差异不明显（Salter，4.4％； Pemberton，3.1％，p = 0.249）。两组的腰部Cobb角之间无显着差异（Salter，3.1°； Pemberton，3.3°，p = 0.906）。在41名儿童（97％）中发现了冠状腰椎弯曲，其中30名具有代偿性弯曲。骨倾斜是骨盆不平衡的影像学参数，与腰部Cobb角最相关（皮尔森相关系数0.59）。哈里斯的髋关节评分和SF-36很好，两组之间没有差异。
结论：从长远来看，我们发现在DDH患儿的治疗中，Salter截骨术和Pemberton髋臼成形术的功能结果或盆腔失衡没有差异。引用本文：Bone Joint J 2016; 98-B：1145-50。

BACKGROUND & AIMS: ABSTRACT:In addition to precautions taken with perioperative surgical techniques, nasal packing and external nasal splinting are frequently employed to ensure the stability of the nasal bones following osteotomies performed during rhinoplasty. However, despite these precautions, nasal bone fragments, generally caused by trauma or healing problems, can approach the midline, progress in a posterior direction and heal with malunion in an infractured manner. Since cavities on the infractured side can result in asymmetries and/or airway narrowing, revision osteotomy is required to correct these problems. Subsequent potential recurrent infractures caused by nasal fragments can easily be prevented with late-absorbed sutures passing through the neighboring holes and opening near the osteotomy lines. This technique would be useful for both primary and secondary rhinoplasty, but especially in secondary rhinoplasty operations. (Level of Evidence: Level IV).

背景与目标： 摘要：除了围手术期采取的预防措施外，经常使用鼻填充和鼻外夹板以确保隆鼻手术后进行截骨术后鼻骨的稳定性。然而，尽管采取了这些预防措施，通常由外伤或愈合问题引起的鼻骨碎片仍可接近中线，向后方向发展，并以骨折的方式愈合畸形。由于在骨折侧的腔可导致不对称和/或气道变窄，因此需要翻修截骨术以纠正这些问题。通过后期吸收的缝线穿过相邻的孔并在切骨线附近打开，可以很容易地防止因鼻腔碎片而引起的潜在的潜在复发性骨折。该技术对于原发性和继发性隆鼻术都将是有用的，但是特别是在继发性隆鼻术中。 （证据级别：IV级）。

BACKGROUND & AIMS: This study was performed to compare soft tissue movements resulting from a series of Le Fort I osteotomies with those predicted for the same cases by means of a computerised software package (COG 3.4). The source material consisted of serial lateral cephalometric radiographs for 25 consecutive patients that had received similar Le Fort I osteotomies primarily to correct an antero-posterior skeletal discrepancy. Generally it was found that many of the digitised points on the facial profile were surprisingly well predicted. In addition, the chin and profile changes resulting from mandibular auto-rotation also were reasonably well predicted. However, in a number of cases prediction was less consistent and this was particularly true in the region of the nose and lips. In such instances, initial size, thickness and the existing morphology of the soft tissues appeared to be important factors. The tendency of the software occasionally to 'cross-over' the plots for the upper and lower lip profile made the judgement in this area of predicted profile change difficult in some cases.

背景与目标： 进行这项研究的目的是将一系列Le Fort I截骨术产生的软组织运动与通过计算机软件包（COG 3.4）预测的相同病例的软组织运动进行比较。原始资料包括连续25例接受了相似的Le Fort I截骨术以纠正前后骨骼差异的患者的连续侧位头颅X线照片。通常发现面部轮廓上的许多数字化点出人意料地得到了很好的预测。此外，下颌自动旋转引起的下巴和轮廓变化也得到了很好的预测。但是，在许多情况下，预测的一致性较差，在鼻子和嘴唇的区域尤其如此。在这种情况下，软组织的初始大小，厚度和现有形态似乎是重要的因素。该软件偶尔会“交叉”上唇和下唇轮廓的趋势，这使得在某些情况下很难在预测轮廓变化的区域进行判断。

BACKGROUND & AIMS: :Two commonly used procedures for early stage hallux rigidus are cheilectomy and decompression metatarsal osteotomy. However, although both procedures were first described several decades ago, a deficit exists in the published data comparing their effectiveness. We performed a retrospective comparative study to examine the results of surgical treatment of early-stage hallux rigidus. A total of 423 subjects were included. Hallux limitus or rigidus had been diagnosed in all patients, who had undergone either cheilectomy or any variation of plantarflexion decompression metatarsal head osteotomy. Of the 423 procedures identified during the study period, 341 (80.6%) were cheilectomy and 82 (19.4%) were decompression osteotomy procedures. The rate of revision procedures was significantly greater in the cheilectomy group (8.21%) than in the osteotomy group (1.22%). Sex, laterality, and body mass index played no role in the rate of revision. The absence of research studies comparing the effectiveness of the 2 procedures has led many practitioners to favor cheilectomy for early-stage hallux rigidus. Decompression metatarsal osteotomies are technically more difficult, involve more risks, and require greater restrictions on postoperative weightbearing compared with cheilectomy. However, our data have shown that within the first 5 postoperative years, decompression osteotomy resulted in a dramatically lower rate of revisional surgery for first metatarsophalangeal joint pathology compared with cheilectomy.

背景与目标： ：早期发生拇趾僵硬的两种常用方法是切唇术和减压meta骨截骨术。但是，尽管这两种方法都是在几十年前首次描述的，但是在比较它们的有效性的公开数据中仍然存在缺陷。我们进行了一项回顾性比较研究，以检查早期僵直的外科手术治疗结果。共纳入423名受试者。在所有患者中均已诊断出拇外翻或僵直，这些患者均接受了切唇切除术或plant屈减压减压meta骨头截骨术的任何改变。在研究期间确定的423例手术中，有341例（80.6％）进行了唇切除术，其中82例（19.4％）为减压截骨术。切唇切除术组的翻修程序率（8.21％）显着高于截骨术组（1.22％）。性别，侧卧度和体重指数对翻修率没有影响。尚无研究比较这两种方法的有效性，导致许多从业者倾向于对早期刚硬性拇囊切除术。与唇切除术相比，减压che骨截骨术在技术上更加困难，涉及更多风险，并且要求在术后负重方面有更大的限制。但是，我们的数据显示，与切唇切除术相比，减压截骨术在进行第一meta趾关节病理的矫正手术率显着降低。

BACKGROUND & AIMS: PURPOSE:Madelung's deformity is usually recognized near the completion of skeletal growth and corrective osteotomy of the radius is frequently performed to treat the deformity and reduce pain. This study reviewed the clinical and radiographic results of a volar approach, ligament release, and dome osteotomy technique for treatment of this deformity. METHODS:Between 1990 and 2000, 26 wrists in 18 patients were treated with a volar ligament release and dome osteotomy of the distal radius. The average age of the patients at the time of surgery was 13 years. All patients were available for review at an average of 23 months after surgery. Radiographs before surgery and at final follow-up evaluation were analyzed for the extent of correction. RESULTS:All patients treated with this corrective osteotomy reported a reduction in pain and improved appearance. Patients showed improvements in forearm supination and wrist extension, with no loss of pronation or flexion. Improvements in the radiographic parameters of radial inclination and lunate subsidence also were observed. Four wrists required concurrent ulnar-sided surgery, and 3 additional wrists required staged ulnar shortening. One patient required a Darrach resection 3 years after the index procedure. CONCLUSIONS:The results of volar dome osteotomy provide improved range of motion, improved appearance, radiographic correction, and pain relief while preserving soft-tissue support for radial rotation around the distal ulna. Long-term follow-up evaluation is ongoing.

背景与目标： 目的：Madelung的畸形通常在骨骼生长即将完成时被发现，并且经常进行correct骨矫正截骨术以治疗畸形并减轻疼痛。这项研究回顾了掌侧入路，韧带释放和穹osteo截骨术治疗该畸形的临床和影像学结果。
方法：在1990年至2000年之间，对18例患者的26个腕部进行了掌韧带释放和and骨远端截骨术。手术时患者的平均年龄为13岁。术后平均23个月，所有患者均可复查。分析手术前和最终随访评估时的X光片的矫正程度。
结果：所有接受这种矫正截骨术治疗的患者均表现出疼痛减轻和外观改善。患者的前臂旋后和腕部伸展均得到改善，但没有旋前或屈曲丢失。还观察到放射状参数的放射状倾角和月球下陷的改善。四只手腕需要同时进行尺侧手术，另外三只手腕需要进行尺骨缩短。索引手术后3年，一名患者需要进行Darrach切除术。
结论：掌侧穹osteo截骨术的结果可改善活动范围，改善外观，影像学矫正和减轻疼痛，同时保留软组织支撑以支持尺骨远端的径向旋转。正在进行长期的跟踪评估。

BACKGROUND & AIMS: :We reviewed prospectively, after skeletal maturity, a series of 24 patients (25 hips) with severe acute-on-chronic slipped capital femoral epiphysis which had been treated by subcapital cuneiform osteotomy. Patients were followed up for a mean of 8 years, 3 months (2 years, 5 months to 16 years, 4 months). Bedrest with 'slings and springs' had been used for a mean of 22 days (19 to 35) in 22 patients, and bedrest alone in two, before definitive surgery. The Iowa hip score, the Harris hip score and Boyer's radiological classification for degenerative disease were used. The mean Iowa hip score at follow-up was 93.7 (69 to 100) and the mean Harris hip score 95.6 (78 to 100). Degenerative joint changes were graded as 0 in 19 hips, grade 1 in four and grade 2 in two. The rate of avascular necrosis was 12% (3 of 25) and the rate of chondrolysis was 16% (4 of 25). We conclude that after a period of bed rest with slings and springs for three weeks to gain stability, subcapital cuneiform osteotomy for severe acute-on-chronic slipped capital femoral epiphysis is a satisfactory method of treatment with an acceptable rate of complication.

背景与目标： ：我们前瞻性地回顾了骨骼成熟后，一系列24例严重急性经时滑脱股骨骨epi的患者，已接受了首都下楔形截骨术治疗。对患者平均随访8年3个月（2年5个月至16年4个月）。在进行最终手术之前，22例患者平均使用了22天（19至35天）的带有“吊带和弹簧”的卧床休息，其中2例仅使用了卧床休息。使用爱荷华州髋关节评分，哈里斯髋关节评分和博耶氏变性疾病的放射学分类。随访时，爱荷华州平均髋关节得分为93.7（69至100），哈里斯平均髋关节得分为95.6（78至100）。退行性关节改变分为19髋0分，4髋1分和2髋2分。无血管坏死的比例为12％（25分之3），而软骨溶解的比例为16％（25分之4）。我们得出的结论是，经过一段带吊索和弹簧的卧床休息三周以获得稳定后，对于严重的急慢性慢性滑脱股骨骨epi，首都下楔形截骨术是令人满意的治疗方法，并发症发生率高。

BACKGROUND & AIMS: :A 23-year-old female presented with pain in the left hip. Radiological examination showed developmental dysplasia of the hip (DDH) combined with acetabular retroversion and posterior wall deficiency. Findings in the physical examination were coincident with femoroacetabular impingement. At surgery, we performed curved periacetabular osteotomy concomitant with arthroscopic labral repair and osteochondroplasty, simultaneously addressing dysplastic acetabulum and femoroacetabular impingement. The final follow-up examination at 18 months showed satisfactory outcome with the D'Aubigne and Postel hip score of 17/18. In addition to accurate diagnosis, the arthroscopic procedure for associated intra- and peri-articular problems seems to help improve the surgical outcome of periacetabular osteotomy performed for patients with DDH.

背景与目标： ：一位23岁的女性左臀部疼痛。影像学检查显示髋关节发育不良（DDH）合并髋臼逆行和后壁缺乏。体格检查的结果与股骨髋臼撞击相吻合。在手术中，我们进行了髋臼弯曲截骨术，同时进行了关节镜下唇修复和骨软骨置换术，同时解决了髋臼发育不良和股骨髋臼撞击。在18个月时进行的最终随访检查显示，D'Aubigne和Postel髋关节评分为17/18，结果令人满意。除了准确的诊断外，关节镜检查可解决相关的关节内和关节周围问题，似乎有助于改善DDH患者髋臼周围截骨术的手术效果。

BACKGROUND & AIMS: :We retrospectively reviewed the results for seventy-five patients (109 feet) in whom a hallux valgus deformity had been corrected with the release of the distal soft tissues, excision of the medial eminence, plication of the medial part of the capsule, and proximal crescentic osteotomy of the first metatarsal. The patients were followed for an average of thirty-four months (range, twenty-four to fifty-six months). The preoperative hallux valgus angle averaged 31 degrees, and the postoperative angle averaged 9 degrees. The preoperative intermetatarsal angle averaged 14 degrees and the postoperative angle, 6 degrees. Ninety-three per cent of the patients were satisfied with the result of the procedure. They stated that, given the same circumstances, they would have the operation again. The most common complication was hallux varus, which occurred in thirteen feet (nine patients). The other complications included recurrence of the hallux valgus in two feet, pain under a fibular sesamoid in one foot, and a tailor's bunion that was unrelated to the operation in one foot. Only five of forty-eight feet that had had a symptomatic plantar keratosis beneath the second metatarsal head preoperatively remained symptomatic postoperatively.

背景与目标： ：我们回顾性研究了75例（109英尺）患者的结果，这些患者的拇外翻畸形已通过远端软组织的释放，内侧隆起的切除，囊内侧部分的折叠以及近端的矫正得到了纠正第一meta骨的新月形截骨术。对患者平均随访34个月（范围为24到56个月）。术前拇外翻角平均31度，术后角平均9度。术前平均间角为14度，术后平均为6度。 93％的患者对手术结果感到满意。他们说，在相同情况下，他们将再次进行手术。最常见的并发症是拇内翻，发生在十三英尺（9例患者）。其他并发症包括两只脚的拇外翻复发，一只脚的腓骨芝麻骨下疼痛以及与一只脚的手术无关的裁缝拇囊炎。术前第二meta骨头下方有症状性足底角化病的四十八只脚中，术后仍保持症状。

BACKGROUND & AIMS: BACKGROUND:This study investigated the radiological factors that correlated with progression of collapse and joint space narrowing after transtrochanteric posterior rotational osteotomy (PRO) for osteonecrosis of the femoral head. METHODS:This study reviewed 51 hips in 47 patients with a mean follow-up of 11 years (5-20). The subjects included 29 males and 18 females with a mean age of 34 years (12-54) at the time of surgery. The 51 hips were divided into two groups based on the radiological outcome (group I: evidence of progression of collapse and/or joint space narrowing, group II: no evidence of either progression of collapse or joint space narrowing). Both clinical and radiological factors were analyzed by both univariate and multivariable analyses. RESULTS:Six hips were categorized as group I and 45 hips were categorized as group II. The postoperative intact ratio and preoperative stage were significantly correlated with the radiological outcome in both univariate (P < 0.0001, P = 0.006) and multivariate (P = 0.0014, P = 0.0039) analysis. The cutoff point for the postoperative intact ratio (the minimum ratio required to prevent both progression of collapse and joint space narrowing) was 36.8 %. CONCLUSIONS:The results of this study indicate that the postoperative intact ratio is one of the main influences on progression of collapse and/or joint space narrowing after PRO, and should be at least 36.8 %. An increased awareness of this critical ratio would be useful for planning the optimal use of this procedure.

背景与目标： 背景：本研究调查了经股骨转子后旋转截骨术（PRO）治疗股骨头坏死后与塌陷和关节间隙变窄相关的放射学因素。
方法：本研究回顾了47例患者的51髋，平均随访11年（5-20​​）。受试者包括29位男性和18位女性，手术时平均年龄为34岁（12-54）。根据放射学结果将这51个髋关节分为两组（第一组：塌陷和/或关节间隙变窄的证据，第二组：没有塌陷或关节间隙变窄的证据）。临床和放射学因素均通过单因素和多因素分析进行​​了分析。
结果：六髋被归为第一组，45髋被归为第二组。单变量（P <0.0001，P = 0.006）和多变量（P = 0.0014，P = 0.0039）分析中，术后完好率和术前分期与放射学结果显着相关。术后完整率的临界点（防止塌陷和关节间隙变窄所需的最小比率）为36.8％。
结论：这项研究的结果表明，术后完好率是PRO后塌陷和/或关节间隙变窄的主要影响因素之一，至少应为36.8％。对该临界比率的进一步了解将有助于计划此程序的最佳使用。

BACKGROUND & AIMS: :We have studied whether the state of the articular cartilage at the time of rotational acetabular osteotomy for dysplasia of the hip affects the outcome 2 to 5.5 years after surgery. Arthroscopy in 57 patients (59 joints) at the time of the operation showed grade-0 changes in seven, grade-1 in nine, grade-2 in 17, grade-3 in 14 and grade-4 in 12 joints, according to the classification of Outerbridge. There was radiological evidence of the progression of arthritis in four joints which were classified at arthroscopy as grade 4. Stepwise regression analysis showed that damage to acetabular or femoral articular cartilage significantly affected the progression of arthritis. We conclude that the short-term results of successful rotational acetabular osteotomy for dysplasia are affected by the state of the articular cartilage.

背景与目标： ：我们研究了髋臼发育不良的旋转髋臼截骨术时关节软骨的状态是否会影响术后2至5.5年的结局。手术时，在57例患者（59个关节）的关节镜检查中，发现7个级别的0级变化，9个级别的1级，17个级别的2级，14个级别的3级和12个级别的4级。外桥的分类。有放射学证据表明四个关节处关节炎进展，在关节镜下被分类为4级。逐步回归分析显示，对髋臼或股关节软骨的损害显着影响了关节炎的进展。我们得出的结论是，成功的旋转髋臼截骨术用于不典型增生的短期结果受关节软骨状态的影响。