title: Transtrochanteric rotational osteotomy for a subchondral insufficiency fracture of the femoral head in young adults.
abstract: BACKGROUND
  While subchondral insufficiency fracture of the femoral head is most frequently seen in elderly patients, this fracture has also been reported in some young individuals.
  
  
  OBJECTIVE
  We asked whether a transtrochanteric rotational osteotomy for a subchondral insufficiency fracture of the femoral head in young adults would (1) provide improvement in functional scores; and (2) lead to healing of the fractures.
  
  
  METHODS
  We retrospectively reviewed five young patients diagnosed with subchondral insufficiency fracture of the femoral head. Nonoperative treatment was administered initially. Four of these patients (average 22.3, years; range, 16-29 years) showed progressive collapse. An anterior rotational osteotomy was performed in these four patients since the fractured area was located in the anterosuperior portion of the femoral head. All patients were followed for a minimum of 2.0 years (average, 4.1 years; range, 2.0-9.1 years).
  
  
  RESULTS
  The average preoperative Harris hip score was 71.6 points, which improved to an average of 97.2 at the latest followup. Radiographically, the fractured lesion healed and no progression of collapse was observed in any of the four patients.
  
  
  CONCLUSIONS
  Anterior rotational osteotomy seems a useful surgical option for treating young patients with subchondral insufficiency fracture of the femoral head if symptoms persist.
authors.affiliation: Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. yamataku@ortho.med.kyushu-u.ac.jp
authors.forename: Takuaki
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Kenyu
authors.initials: K
authors.lastname: Iwasaki
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Iwamoto
mesh_terms: D000328:Adult; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005270:Femur Head / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D015775:Fractures, Stress / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult