| Objective: To introduce the periacetabular triple osteotomy that is also named as modified TÇ’nnis triple pelvic osteotomy for the treatment of adolescence and adult acetabular dysplasia. the hip function, it's X-ray computed radiography, computed tomography and three-dimensional computed tomography were analyzed pre-operation, post-operation and following-up; simultaneously to contrast and study ilium prolongation osteotomy, Salter ilium osteotomy, Sutherland double pelvic osteotomy and modified TÇ’nnis triple pelvic osteotomy in order to instruct the three-dimensional change of the reducible relation of acetabulum and femoral head after the periacetabular triple osteotomy.Methods: From March 2000 to February 2003, my department had modified T?nnis triple pelvic osteotomy and designed preiacetabular triple osteotomy creatively in China, 22 patients with acetabular dysplasia were operated upon with the new therapy because of limp of limb, hypodynamia and joint pain. The mean age of thepatients at the time of the surgery was 13 years (range,7~20 years), male:female=1:1, left:right=12:10. Congenital disorder was 64 percent in the cause of hip dysplasia, aseptic necrosis of head of femur was 36%. Preoperatively, all patients had crippled, hypodynamic limb and outpouching trochanter of femur, 50% of the patients had joint pain, the average duration of the symptoms was 2 years (4 months to 6 years). There were 20 cases with unilateral hip dysplasia, the suffering limbs' length had a shortage of average 2.6cm (1.8~3.2cm) from entopic computed radiography including bilateral hip, knee and ankle joints and 2 cases with bilateral hip dysplasia, the left hip of 1 male and the right hip of 1 female were treated. They had positive Trendelenburg sign. The average range of abducent motion (ROM) of the hips was 70? (65?~75?), the other motions were normal in most patients. Computed radiography preoperation showed: CE angle was -25?~15? with an average of 8.4?; Sharp angle 45?~70?, average 58.6?; AHI 31%~76%, average 61,4%; ACP angle 100?~170?, average 139.8?. The spatium of hips were normal or narrow mildly (Shenton's line broken). Computed tomography showed: ACEA justo major; AASA and AAVA justo minor. The anterolateral part of femoral head was covered very deficiently by the acetabulum. Three-dimensional computed tomography showed: hip dysplasia; the obducent graduation of femoral head was I to II; ALAL, PLAL andLAI justo major; TR justo minor. The anterior, lateral and superior part of femoral head was covered obviously deficiently and the femoral heads had subluxation on variant degree, but anteversion and collodiaphysial angle of femoral neck changed indistinctively.Our modifications to TÇ’nnis triple pelvic osteotomy as follows: 1. skeletal traction through supracondyle of femur or release of adductor and musculus iliopsoas preoperation; 2. two incisions and creative apparatus for the ramus superiorossis of ischii and publis, ilium osteotomy; 3. after the acetabulum was rotated to anterior ,lateral and inferior direction until reduction of the femoral head, a triangle bone from the ilium was inserted and fixed with multiple pins; 4. drainage in the wound for 2 days, skin traction for 2 weeks and dirigation, the patients walked after 8~10 weeks postoperation.From March 2000 to February 2003, 5 patients with limb shortening deformity were treated with ilium prolongation osteotomy. The mean age of the patients was 16 years (9~34 years), male:female=2:3, left:right=3:2. Entopic X-ray computed radiography including bilateral hip, knee and ankle joints showed: the suffering limbs' length had a shortage of average 2.7cm(2.3~3.2cm). Sharp angle and the limb's length from computed radiography were measured and compared pre- and post operation.To imitate Salter ilium, Sutherland double andmodified TÇ’nnis triple pelvic osteotomy making use of six Chinese adult preservative cadaver hemipelvis (including proximal one-third femur) individuly, measure and study Sharp angle, ALAL, PLAL, LAI an...
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