Treatment of congenital dislocation of hip joint with subtrochanteric rotary osteotomy. Femoral subtrochanteric rotational osteotomy. Femoral rotation osteotomy can correct severe femoral neck anteversion deformity. The femoral head can be reduced without tension by shortening femoral osteotomy. Wedge osteotomy can also be performed at the same time to correct coxa valgus or coxa varus deformity. Rotational osteotomy can be performed at the lower part of the femoral trochanter or the upper part of the femoral condyle. If necessary, femoral shortening can be performed simultaneously with wedge osteotomy to correct coxa varus and valgus.

First, the surgical steps Osteotomy and internal fixation stages are the same as osteotomy in orthopedic surgery.

Osteotomy correction: The rotation angle that needs to be corrected after bone cutting can be judged by the following two methods:

After the osteotomy plane was determined, 90-degree vertical bone marks were cut at the lateral cortex and the anterior midpoint of the femur with the periphery of the femur as the circumference (Figure 1). Then cut the femur, and correct the external rotation of the distal femur with bone marks according to the preoperative design and the angle of correction during operation (measured femoral anteversion-15 degrees) (Figure 2).

First, rotate the lower body so that the front end of femur faces the center of acetabulum, and the femur inclines forward by about 15 degrees. Place one Kirschner wire in the horizontal position of the femur on the tibial plane, and place the other Kirschner wire in front of the femur at a positive angle below the plane. The horizontal needle keeps the position of the special person unchanged and prevents the femur from rotating. After osteotomy or wire saw cutting, cut the bone to make the two needles flush, check whether the tibia faces forward, and measure the spur in front of the ilium between the first and second toes. It is considered that the tibia crosses the midpoint and the correction is satisfactory.

Internal fixation: in the position of rotational correction, fix the femoral side with 4-hole steel plate screws to make the osteotomy ends closely contact.

Suture: clean the wound and sew the incision layer by layer. Fix the hips with herringbone plaster.

Second, postoperative treatment: 6 ~ 8 weeks after operation, remove the plaster external fixation and exercise gradually. X-ray shows that the bone is healed and can walk with load.

Take out the steel plate and screw after the bone is healed.

Femoral subtrochanteric osteotomy is a surgical method to treat femoral head diseases.