title: Anteromedial wedge reduction osteotomy  for the treatment of femoral head deformities.
abstract: Aspherical femoral head deformity has poor a prognosis which can lead to early arthritic changes in young adults. The intraartricular anteromedial wedge reduction osteotomy restores sphericity of the femoral head. We performed seven anteromedial wedge reduction osteotomies. Clinical indications were pain, limp and restriction of movement of the hip joint. The mean age at time of the surgery was 13.3 years. The aetiology of the femroal head deformity was Perthes disease in six patients and in one patient, multiple epiphyseal dysplasia. All seven hips were classified as Stulberg V before surgery. At a mean follow-up of 17.4 months the Harris hip score increased from a mean of 55.4 preoperatively to a mean of 84.8 postoperatively. The final results were Stulberg IV in one hip, Stulberg III in four hips and Stulberg II in two hips postoperatively. The capital diaphyseal ratio dropped from average of 1.57 preoperatively to 1.21 postoperatively. No signs of osteonecrosis were recorded. One patient suffered a subluxation of the femoral head. The anteromedial wedge reduction osteotomy has good short-term results in aspherical incongruent hips.
authors.affiliation: Department of Orthopaedics of the Institute for Postgraduate Medical Education and 1st Faculty of Medicine Charles University and Teaching Hospital Na Bulovce, Prague, Czech Republic 18000. michburian@gmail.com
authors.forename: Michal
authors.initials: M
authors.lastname: Burian
authors.forename: Pavel
authors.initials: P
authors.lastname: Dungl
authors.forename: Ondrej
authors.initials: O
authors.lastname: Nanka
authors.forename: Jiri
authors.initials: J
authors.lastname: Chomiak
authors.forename: Martin
authors.initials: M
authors.lastname: Ostadal
authors.forename: Monika
authors.initials: M
authors.lastname: Frydrychova
authors.forename: Radovan
authors.initials: R
authors.lastname: Kubes
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005270:Femur Head / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome