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。

BACKGROUND & AIMS: BACKGROUND:Hereditary multiple osteochondromas (hereditary multiple exostoses, HME) is a rare genetic disease characterized by the development of benign osteocartilaginous tumors that may cause severe limb deformities and early onset osteoarthritis. Total knee arthroplasty (TKA) is the method of choice for the treatment of advanced gonarthrosis, however the surgical management with coexisting severe axial limb deformity remains unclear. CASE PRESENTATION:65-year-old man with HME and extra-articular multi-axial limb deformity was admitted to the orthopedic department due to chronic knee pain and limited range of motion caused by secondary osteoarthritis. Regarding to the clinical and radiological examinations, after preoperative planning he was qualified to a one-stage TKA combined with tibial shaft osteotomy (TSO). In a one year follow-up full bone union was confirmed with no signs of implant loosening or prosthesis displacement. Patient was very satisfied, did not report any joint pain and has sufficient range of motion without knee instability. CONCLUSION:The improvement of mechanical axis during TKA is a crucial factor for achieve operative success and long implant survival. Despite the higher risk of complication rate in comparison to two-stage treatment, one-stage TKA with simultaneous TSO should be a considerable method for patients with osteoarthritis and multiaxial limb deformities. This method can give a good clinical and functional outcomes, however should be performed subsequently to careful preoperative planning and proper patient qualification.

背景与目标： 背景：遗传性多发性骨软骨瘤（遗传性多发性外生糖，HME）是一种罕见的遗传病，其特征是良性骨软骨肿瘤的发展，可能导致严重的肢体畸形和早期发作的骨关节炎。全膝关节置换术（TKA）是治疗晚期淋病的首选方法，但是尚无合并严重的肢体严重轴畸形的手术治疗方法。
病例介绍：由于慢性膝关节疼痛和继发性骨关节炎引起的活动范围有限，患有HME和关节外多轴肢体畸形的65岁男性被纳入骨科。关于临床和放射学检查，在术前计划后，他有资格接受一期TKA联合胫骨干截骨术（TSO）。在一年的随访中，确认了全骨结合，没有植入物松动或假体移位的迹象。患者非常满意，没有报告任何关节痛，并且活动范围足够，没有膝盖不稳定。
结论：TKA期间机械轴的改善是获得手术成功和长植入物生存的关键因素。尽管与两阶段治疗相比，并发症发生率更高，但是对于骨关节炎和多轴肢体畸形患者，一阶段TKA并发TSO应该是一种相当不错的方法。该方法可产生良好的临床和功能结果，但应在术前仔细计划和适当的患者资格后进行。

BACKGROUND & AIMS: BACKGROUND:The main objective of every new development in total hip arthroplasty (THA) is the longest possible survival of the implant. Periprosthetic stress shielding is a scientifically proven phenomenon which leads to inadvertent bone loss. So far, many studies have analysed whether implanting different hip stem prostheses result in significant preservation of bone stock. The aim of this preclinical study was to investigate design-depended differences of the stress shielding effect after implantation of a selection of short-stem THA-prostheses that are currently available. METHODS:Based on computerised tomography (CT), a finite elements (FE) model was generated and a virtual THA was performed with different stem designs of the implant. Stems were chosen by osteotomy level at the femoral neck (collum, partial collum, trochanter sparing, trochanter harming). Analyses were performed with previously validated FE models to identify changes in the strain energy density (SED). RESULTS:In the trochanteric region, only the collum-type stem demonstrated a biomechanical behaviour similar to the native femur. In contrast, no difference in biomechanical behaviour was found between partial collum, trochanter harming and trochanter sparing models. All of the short stem-prostheses showed lower stress-shielding than a standard stem. CONCLUSION:Based on the results of this study, we cannot confirm that the design of current short stem THA-implants leads to a different stress shielding effect with regard to the level of osteotomy. Somehow unexpected, we found a bone stock protection in metadiaphyseal bone by simulating a more distal approach for osteotomy. Further clinical and biomechanical research including long-term results is needed to understand the influence of short-stem THA on bone remodelling and to find the optimal stem-design for a reduction of the stress shielding effect.

背景与目标： 背景：全髋关节置换术（THA）的每项新进展的主要目的是使植入物的生存期最长。假体周围应力屏蔽是一种经过科学证明的现象，会导致意外的骨质流失。到目前为止，许多研究已经分析了植入不同的髋关节假体是否能显着保留骨储备。这项临床前研究的目的是研究植入目前可用的短柄THA假体后，取决于设计的应力屏蔽效果差异。
方法：基于计算机断层扫描（CT），生成有限元（FE）模型，并使用不同的植入物茎设计进行虚拟THA。通过股骨颈截骨术水平选择茎（胶原蛋白，部分胶原蛋白，转子粗细，转子粗细损伤）。使用先前验证的有限元模型进行分析，以识别应变能密度（SED）的变化。
结果：在股骨转子区，只有collum型茎表现出与天然股骨相似的生物力学行为。相反，在部分肢体，转子损伤和转子节备模型之间，在生物力学行为上没有发现差异。所有的短茎假体均显示出比标准茎更低的应力屏蔽。
结论：基于这项研究的结果，我们不能证实当前的短茎THA植入物的设计在截骨水平方面导致不同的应力屏蔽效果。某种程度上出乎意料的是，我们通过模拟更远侧的截骨方法，发现了meta骨的骨保护。需要进一步的临床和生物力学研究，包括长期结果，以了解短柄THA对骨重塑的影响，并找到降低应力屏蔽效果的最佳茎设计。

BACKGROUND & AIMS: Background:Radial club hand (RCH) is characterized by a wide array of hand and forearm anomalies. Various treatment approaches have been described depending upon the stages of RCH. The major drawback of these studies is that the effectiveness of these interventions was reported on clinical and radiological outcomes. With the increasing focus on patient-centered care nowadays, we wanted to identify the components associated with functioning and evaluate the effectiveness of two surgical procedures on functional outcomes using the International Classification of Functioning, Disability and Health (ICF)-based tools. Materials and Methods:We identified 14 children from our records (nine boys, five girls) with a mean age of 5.6 years, classified as Bayne types III-IV and classified them into two groups; those who were operated by centralization (group 1) and ulnarization of the carpus with ulnar shortening osteotomy procedure (group 2). The outcomes were evaluated by the brief ICF core set for the child and youth with cerebral palsy up to the age of 5 and the brief ICF core set for hand conditions for a period of 1 year after surgery. Results:The results showed that both the operative techniques showed improvement in the structure component (s730-structure of upper extremity). ICF categories of d445-hand and arm use, d530-toileting, and d880-engagement in play showed a change in frequencies of more than 40% after surgery and were maintained till follow-up. However, categories related to muscle power functions (b730), muscle tone (b735), fine hand use (d440), hand and arm use (d445) and engagement in play (d880) showed no significant improvement (p > 0.05). There were no differences between both the surgical procedures in improving the outcomes (p > 0.05). Conclusion:We conclude that surgical techniques may be more appropriate to improve the cosmetic or structural appearance of the upper extremity than functioning.

背景与目标： 背景：Radi手（RCH）的特征是手和前臂异常。已经根据RCH的阶段描述了各种治疗方法。这些研究的主要缺点是，这些干预措施的有效性在临床和放射学结果上已有报道。如今，随着对以患者为中心的护理的日益关注，我们希望使用基于国际功能，残疾与健康分类（ICF）的工具来识别与功能相关的组件，并评估两种外科手术对功能结果的有效性。
材料和方法：我们从记录中识别出14名平均年龄为5.6岁的儿童（九个男孩，五个女孩），被分类为贝恩III-IV型并将其分为两组;那些通过集中（第1组）和尺骨尺骨缩短截骨术（第2组）进行尺骨化手术的患者。通过对5岁以下的儿童和青少年脑瘫的简短ICF核心集和对术后1年的手部状况的简短ICF核心集评估结局。
结果：结果表明，两种手术方法均改善了结构成分（上肢s730结构）。 ICF类别的d445手和手臂使用，d530训练和d880参与游戏在手术后的频率变化超过40％，并且一直保持到随访。但是，与肌肉力量功能（b730），肌肉张力（b735），好手使用（d440），手和手臂使用（d445）和游戏参与（d880）相关的类别没有显着改善（p> 0.05）。两种手术方法在改善结局方面无差异（p> 0.05）。
结论：我们得出结论，外科手术技术可能比功能性手术更适合于改善上肢的外观或结构外观。

BACKGROUND & AIMS: PURPOSE:There exist not much data regarding the surgical treatment of pure congenital kyphosis (CK) in the literature. The purpose of this study was to evaluate the results of closing wedge osteotomy with posterior instrumented fusion in patients with congenital kyphotic deformity. METHODS:We retrospectively evaluated the radiographical results of 10 patients who were subject to closing wedge vertebral osteotomy and posterior instrumented fusion due to CK. The mean age of the patients at surgery was 12.6 ± 3.72 years (range 8-18 years). Radiographical measurements including local kyphosis, correction loss, global kyphosis and sagittal balance values were noted for the preoperative, postoperative and final follow up periods, respectively. The data obtained from those periods underwent statistical analysis. RESULTS:Average follow-up period was 51.8 ± 29.32 months (range 26-96 months). The mean local kyphosis angle was 67.7° ± 15.64° (range 42°-88°) prior to the surgery, 31.5° ± 17.12 (range 14°-73°) following the surgery and 31.9° ± 15.98° (range 14°-71°) during the follow up-period, respectively (p < 0.05). A correction rate of 53.5 % was reported at the final follow up. Average sagittal balance was measured as 33.1 ± 24.48 mm (range 2-77 mm) prior to the surgery, 20.8 ± 15.46 mm (range 5-46 mm) following the surgery (p < 0.05) and 14.1 ± 9.2 mm (range 0-30 mm) during follow-up period (p > 0.05). Complications consisted of a rod fracture due to pseudoarthrosis, an implant failure with loosening of screws and a proximal junctional kyphosis. No neurological deficit or deep infection were encountered in any of the patients in the study group. CONCLUSION:Closing wedge osteotomy with posterior instrumented fusion is an efficient method of surgical treatment in terms of sagittal balance restoration and deformity correction in patients with congenital kyphosis.

背景与目标： 目的：关于纯先天性后凸畸形（CK）的外科治疗资料还很少。这项研究的目的是评估先天性后凸畸形患者采用后路器械融合术进行楔形截骨术的结果。
方法：我们回顾性评估了10例因CK而行闭合楔形椎体截骨术和后路器械融合术的患者的影像学结果。手术患者的平均年龄为12.6±3.72岁（范围8-18岁）。分别记录术前，术后和最终随访期间的影像学测量值，包括局部后凸畸形，矫正损失，整体后凸畸形和矢状平衡值。从这些时期获得的数据进行了统计分析。
结果：平均随访时间为51.8±29.32个月（范围26-96个月）。手术前的平均局部后凸角为67.7°±15.64°（范围42°-88°），手术后的平均局部后凸角为31.5°±17.12（范围14°-73°），手术后为31.9°±15.98°（范围14°-在随访期间分别为71°）（p <0.05）。在最后的随访中报告的矫正率为53.5％。术前测量的平均矢状位平衡为33.1±24.48 mm（范围2-77 mm），术后测量为20.8±15.46 mm（范围5-46 mm）（p <0.05）和14.1±9.2 mm（范围0-随访期间（30 mm）（p> 0.05）。并发症包括假性关节炎引起的杆断裂，螺钉松动引起的植入失败以及近端结节性后凸畸形。在研究组的任何患者中都没有遇到神经功能缺损或深层感染。
结论：先天性后凸畸形在矢状面平衡恢复和畸形矫正方面采用后路器械融合封闭楔形截骨术是一种有效的外科治疗方法。

BACKGROUND & AIMS: :In this retrospective observational study, I aimed to report long-term follow-up results of femoral varus osteotomy in the treatment of Perthes disease patients who were between 6 and 8 years old at the onset of the disease with Herring B and C hip involvement. I also aimed to compare 2 different osteotomy techniques: open-wedge and closed-wedge femoral varus osteotomies.Patients with Perthes disease treated with femoral varus osteotomies were invited for final examination. Twenty two hips of 19 patients were evaluated. Mean follow-up period was 15.2 years. Patients were divided into 2 homogenous groups according to femoral osteotomy technique. In Group A (12 hips) open-wedge osteotomy, and in Group B (10 hips) closed-wedge osteotomy was performed.There were 15 male (78.9%) and 4 female (21.1%) patients. The median age at the onset of the disease was 7 years in Group A and B. The mean follow-up period was 16.2 years in Group A, and 11.4 years in Group B. According to Stulberg classification 5 hips (22.7%) were healed as Class I, 4 hips (18.2%) were healed as Class II, 12 hips (55.5%) were healed as Class III, and 1 hip (4.6%) was healed as Class IV. Also in Group A 4 hips (33.3%) were healed as Class I or II, 7 hips (58.3%) were healed as Class III, and 1 hip (8.3%) was healed as Class IV; in Group B 5 hips (50.0%) were healed as Class I or II, and 5 hips were healed as Class III (50.0%). There was no significant difference between the groups. According to Iowa scale, mean values were 92.6 in Group A and 92.4 in Group B. There was no significant difference between the groups. At the final follow-up mean center-edge angles of Group A and B were 16 and 22, the difference was significant.Long-term follow-up results showed that femoral varus osteotomy was an effective treatment method in Perthes disease patients who were between 6 and 8 years old with Herring B and C hip involvement at the onset of the disease. Hip joint congruency was obtained with femoral varus osteotomies, and closed-wedge osteotomy served more favorable center-edge angle results.

背景与目标： ：在这项回顾性观察性研究中，我旨在报告股骨内翻截骨术治疗Perrings病患者（发病于6到8岁，患有鲱鱼B和C髋关节）的长期随访结果。我还打算比较两种不同的截骨术：开放式和封闭式股骨内翻截骨术。邀请接受Perthes病的股骨内翻截骨术患者进行最终检查。对19名患者的22髋进行了评估。平均随访期为15。2年。根据股骨截骨术将患者分为2组。 A组（12髋）行楔形截骨，B组（10髋）行楔形截骨，男15例（78.9％），女4例（21.1％）。该疾病发作的中位年龄在A组和B组为7岁。A组的平均随访期为16.2年，B组的平均随访期为11.4年。根据Stulberg的分类，5愈了5髋（22.7％）。 I类为4髋（18.2％），II类为12髋（55.5％），III类为1髋（4.6％）。同样在A组中，有4髋（33.3％）被治愈为I级或II级，有7髋（58.3％）被治愈为III级，有1髋（8.3％）被治愈为IV级。在B组中，有5髋（50.0％）被治愈为I或II级，有5髋被治愈为III类（50.0％）。两组之间无显着差异。根据爱荷华州量表，A组平均值为92.6，B组平均值为92.4。两组之间无显着差异。在A组和B组的最终随访平均中心边缘角度分别为16和22时，差异显着。长期随访结果表明，股骨内翻截骨术是治疗以下两种之间的Perthes病患者的有效方法： 6和8岁，发病时出现鲱鱼B和C髋关节。股骨内翻截骨术可实现髋关节全合，而楔形截骨术可提供更有利的中心边缘角度结果。