Clinical And Anatomic Research Of Acetabuloplasty Illac Osteotomy

Objective To provide a new method for the treatment of adult acetabular dysplasia and sublaxation.Methods The vessels provided for the body of ilium aboved acetabulum and the anatomic relationship between the site of osteotomy and its surrounding structures were observed on 40 sides adult cadaveric buttocks . And imitative osteotomy were made on 2 cases of adult cadaveric buttocks. Nine cases (9 hips) of acetabular dysplasia were operated with iliac osteotomy performed above acetabulum. The first part of iliac osteotomy was dome from anterior to posterior above the roof of acetabulum, another part of osteotomy came from post-superior of acetabulum to the posterior of anterior superior iliac spine at 3 cm appeared as arc-shaped. The fragment which blood vessels and muscles attached to could be moved outward and slide situation downward and backward to cover the femoral head. The fragment and ilium could be fixed with two or three pins. The X-ray and CT changes of the improvement of acetabulum capacity and the union condition were be observed after operation.Results The vessels provided for the body of ilium aboved acetabulum were nutrient arteries and branches of periost came from deep branch of superior gluteal artery and deep iliac circumflex artery. The occurrent rate of deep-superior branch of superior gluteal artery was 70.6%. It's caliber was 1.43±0.36mm .The occurrent rate of deep-inferior branch of superior glateal artery was 82.4% .and it's caliber was 1.36±0.41 mm .The occurrent rate of deep iliac circumflex artery was 100%. It's caliber was 0.35±0.41 mm . Sartorius muscles and rectus femoris muscle inserted into the fragment. The fragment could be moved to cover the femoral head. The fragment had better stability especially when pin fixation had been made through both of fragment and ilium. Nine hips had been followed-up. The femoral heads have nice covered. All of the fragment and ilium were union, and the symptoms have been ameliorated nicely. t-test of the results of CT shows that the cover of acetabulum were improved obviously (p<0.001)Conclusion The blood supply of the body of ilium aboved acetabulum was plentiful .The fragment of osteotomy could be moved outward and slide down and backward to cover the femoral head . The fragment had better stability especially when pin fixation had been made. This iliac osteotomy can extend the bulk of acetabulum validly, and the pressure of femoral head can be reduced. The effects of the operation are satisfactory.