title: Open-reduction and intertrochanteric osteotomy for osteonecrosis and extrusion of the femoral head in adolescents.
abstract: Extrusion of the femoral head during late childhood and adolescence can be caused by tissue interposition following traumatic hip dislocation, inflammatory joint disease, or avascular necrosis with flattening of the femoral head. We report our experience of treatment by reorientation of the extruded femoral head with combined open-reduction and intertrochanteric osteotomy in seven young patients with Ficat stage III or IV avascular necrosis. Six of the seven patients showed improvement of pain and limp. They also had radiographic improvement of joint space and congruency, which suggests that the degenerative process and further surgery may be delayed.
authors.affiliation: Department of Orthopaedic Surgery, University of Berne, Inselspital, Switzerland.
authors.forename: H P
authors.initials: HP
authors.lastname: Nötzli
authors.forename: L B
authors.initials: LB
authors.lastname: Chou
authors.forename: R
authors.initials: R
authors.lastname: Ganz
mesh_terms: D000293:Adolescent; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome