title: Operative treatment of avascular necrosis of the femoral head after proximal femur fractures in adolescents.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Patients treated for ANFH had good medium-term outcomes after THR for total necrosis and also after VITO for partial necrosis.
authors.affiliation: Department of Surgery of the 1st Faculty of Medicine, Charles Univeristy, Thomayer University Hospital, Vídeňská 800, Prague-4, Czech Republic. bartonicek.jan@seznam.cz
authors.forename: Jan
authors.initials: J
authors.lastname: Bartoníček
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Vávra
authors.forename: Radek
authors.initials: R
authors.lastname: Bartoška
authors.forename: Petr
authors.initials: P
authors.lastname: Havránek
mesh_terms: D000293:Adolescent; D000328:Adult; D016723:Bone Remodeling; D015331:Cohort Studies; D060905:Coxa Vara / Q000209:etiology / Q000601:surgery; D004185:Disability Evaluation; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005270:Femur Head / Q000473:pathology / Q000601:surgery*; D005271:Femur Head Necrosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D006304:Health Status; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010027:Osteotomy; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult