The incidence of stress fracture following peri-acetabular osteotomy

被引:32
作者
Malviya, A. [1 ]
Dandachli, W. [1 ]
Beech, Z. [1 ]
Bankes, M. J. [1 ]
Witt, J. D. [1 ]
机构
[1] Univ Coll London Hosp, Guys & St Thomas Fdn NHS Hosp Trust, Newcastle Upon Tyne, Tyne & Wear, England
关键词
BERNESE PERIACETABULAR OSTEOTOMY; LOAD-TRANSFER; HIP; PREDICTORS;
D O I
10.1302/0301-620X.97B1.34525
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Stress fractures occurring in the pubis and ischium after peri-acetabular osteotomy (PAO) are not well recognised, with a reported incidence of 2% to 3%. The purpose of this study was to analyse the incidence of stress fracture after Bernese PAO under the care of two high-volume surgeons. The study included 359 patients (48 men, 311 women) operated on at a mean age of 31.1 years (15 to 56), with a mean follow-up of 26 months (6 to 64). Complete follow-up radiographs were available for 348 patients, 64 of whom (18.4%) developed a stress fracture of the inferior pubic ramus, which was noted at a mean of 9.1 weeks (5 to 55) after surgery. Most (58; 91%) healed. In 40 of the patients with a stress fracture (62.5%), pubic nonunion also occurred. Those with a stress fracture were significantly older (mean 33.9 years (16 to 50) vs 30.5 years (15 to 56), p = 0.002) and had significantly more mean pre-operative deformity: mean centre-edge angle (9.8 degrees (-9.5 to 35) vs 12.4 degrees (-33 to 28), p = 0.04) and mean Tonnis angle (22.8 degrees (0 to 45) vs 18.7 degrees (-2 to 38), p < 0.001). The pubic nonunion rate was significantly higher in those with a stress fracture (62.5% vs 7%, p < 0.001), with regression analysis revealing that these patients had 11.8 times higher risk than those without nonunion.
引用
收藏
页码:24 / 28
页数:5
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