International orthopaedics · 2011
Operative treatment of avascular necrosis of the femoral head after proximal femur fractures in adolescents.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Bartoníček Jan, Vávra Jaroslav, Bartoška Radek, Havránek Petr
Аннотация
PURPOSE: Our aim was to assess operative treatment for post-traumatic avascular necrosis of the femoral head (ANFH) in adolescents.
METHODS: Eleven patients with an average age of 17 (range 14-26) years were operated up on for ANFH after proximal femoral fractures. The average interval between injury and reconstructive surgery was four (range two to eight) years. The average follow-up of the entire cohort was 89 (range 48-132) months. Five patients with total ANFH were treated by total hip replacement (THR). Six patients with partial ANFH were treated with valgus intertrochanteric osteotomy (VITO).
RESULTS: In all patients, operation improved hip function. The average preoperative Harris Hip Score (HHS) was 70 points and average postoperative HHS was 97 points. Comparison of magnetic resonance imaging (MRI) scans before and after VITO demonstrated resorption of the necrotic segment of the femoral head and its remodelling in all six patients with partial ANFH. A complication was encountered in one patient.
CONCLUSION: Patients treated for ANFH had good medium-term outcomes after THR for total necrosis and also after VITO for partial necrosis.
METHODS: Eleven patients with an average age of 17 (range 14-26) years were operated up on for ANFH after proximal femoral fractures. The average interval between injury and reconstructive surgery was four (range two to eight) years. The average follow-up of the entire cohort was 89 (range 48-132) months. Five patients with total ANFH were treated by total hip replacement (THR). Six patients with partial ANFH were treated with valgus intertrochanteric osteotomy (VITO).
RESULTS: In all patients, operation improved hip function. The average preoperative Harris Hip Score (HHS) was 70 points and average postoperative HHS was 97 points. Comparison of magnetic resonance imaging (MRI) scans before and after VITO demonstrated resorption of the necrotic segment of the femoral head and its remodelling in all six patients with partial ANFH. A complication was encountered in one patient.
CONCLUSION: Patients treated for ANFH had good medium-term outcomes after THR for total necrosis and also after VITO for partial necrosis.
Предметные рубрики MeSH
AdolescentAdultBone RemodelingCohort StudiesCoxa VaraDisability EvaluationFemaleFemoral Neck FracturesFemur HeadFemur Head NecrosisFracture Fixation, InternalHealth StatusHip JointHumansMagnetic Resonance ImagingMaleOsteotomyPostoperative ComplicationsPlastic Surgery ProceduresRecovery of FunctionTreatment OutcomeYoung Adult