[Treatment of segmental ischemic necroses of the head of femur with intertrochanteric flexion-osteotomy (author's transl)].
We call conditions with focal necroses in the head of femur "segmental necroses". Where possible we prefer to treat this condition with intertrochanteric displacement osteotomy, either with flexion- or varus displacement. As with arthrosis of the hip-joint the effects of displacement osteotomy are: reduction of tension of the muscles acting on the joint and increase in the leverage of the abductors reduce the work-load of the joint. An intact sector of the femoral head is placed into the weightbearing position and the necrotic segment is relieved. Immediate freedom from pain is supposed to be due to a normalization of the internal pressure in the marrow-cavity. For radiologic examination of segmental necroses of the femoral head tangential films (after Schneider) in addition to AP and axial films have proved useful. Early results of 16 flexion osteotomies for segmental necrosis of the head of femur, followed up for 6-34 months after operation (and further for up to 54 months), are encouraging. Impressive improvement of pain occurred in 14, of gait in 11 patients. The range of movement of the diseased joints, however, was not essentially increased.
D000328:Adult; D005270:Femur Head / Q000098:blood supply; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D005684:Gait; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007511:Ischemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D010146:Pain; D011859:Radiography
Die Behandlung segmentaler, ischämischer Hfkkopfnekrosen mit der intertrochantären Flexionsosteotomie