PURPOSE: The study evaluates long-term results in patients treated by valgus intertrochanteric osteotomy (VITO) for partial avascular necrosis of the femoral head (ANFH) after fracture of the femoral neck in adolescent age. Although this method is mentioned in literature frequently, there are only few studies in the literature dealing with it in detail. METHODS: Authors evaluated five patients at the interval of 15 to 20 years following VITO. The mean age of the patients at the time of injury was 13.6 years and at the time of VITO 16.7 years. The studied parameters included resorption of necrotic segment of femoral head, development of posttraumatic osteoarthritis and leg shortening. RESULTS: Comparison of radiographs and MRI scans before and after VITO showed resorption of the necrotic segment of the femoral head and its remodeling in all five patients. However, two patients gradually developed slight osteoarthritic changes. In one patient, remodeling of the femoral head occurred during the first 6 years postoperatively. Subsequently, the patient developed severe osteoarthritis with marked clinical symptoms. CONCLUSION: VITO can improve the long-term function of the hip joint in adolescents with ANFH after a femoral neck fracture, but cannot restore completely the original shape and structure of the femoral head.

• Klíčová slova
• Avascular necrosis, Femoral neck fractures, Intertrochanteric osteotomy, Long-term results,
• MeSH
• fraktury krčku femuru * diagnostické zobrazování   etiologie   chirurgie   MeSH
• kyčelní kloub chirurgie   MeSH
• lidé MeSH
• mladiství MeSH
• nekróza hlavice femuru * diagnostické zobrazování   etiologie   chirurgie   MeSH
• osteoartróza * MeSH
• osteotomie škodlivé účinky   metody   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH

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.

• MeSH
• coxa vara etiologie   chirurgie   MeSH
• dospělí MeSH
• fraktury krčku femuru komplikace   patologie   chirurgie   MeSH
• hlavice femuru patologie   chirurgie   MeSH
• kohortové studie MeSH
• kyčelní kloub patofyziologie   chirurgie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nekróza hlavice femuru etiologie   patologie   chirurgie   MeSH
• obnova funkce MeSH
• osteotomie MeSH
• pooperační komplikace MeSH
• posuzování pracovní neschopnosti MeSH
• remodelace kosti MeSH
• vnitřní fixace fraktury škodlivé účinky   MeSH
• výsledek terapie MeSH
• zákroky plastické chirurgie MeSH
• zdravotní stav MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH