Transtrochanteric Rotational Osteotomy for a Subchondral Insufficiency Fracture of the Femoral Head in Young Adults
Transtrochanteric Rotational Osteotomy for a Subchondral Insufficiency Fracture of the Femoral Head in Young Adults
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DOI：
10.1007/s11999-010-1364-y
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发表时间：
2010-12-01
影响因子：
4.2
通讯作者：
Iwamoto, Yukihide
中科院分区：
文献类型：
--
作者：
Yamamoto, Takuaki;Iwasaki, Kenyu;Iwamoto, Yukihide
虽然股骨头软骨下不全性骨折最常见于老年患者，但也有报道称这种骨折发生在一些年轻人身上。问题/目的：我们询问年轻人股骨头软骨下功能不全骨折行经粗隆旋转截骨术是否会(1)改善功能评分；(2)导致骨折愈合。方法回顾性分析5例年轻股骨头软骨下不全骨折患者的临床资料。最初给予非手术治疗。其中4例患者（平均22.3岁，年龄范围16-29岁）表现为进行性崩溃。由于骨折区位于股骨头前上部分，这4例患者均行前路旋转截骨术。所有患者至少随访2.0年（平均4.1年，范围2.0-9.1年）。结果Harris髋关节评分术前平均为71.6分，最近一次随访时平均为97.2分。影像学检查显示，骨折灶愈合，4例患者均未见塌陷进展。结论如果症状持续存在，前路旋转截骨术是治疗年轻股骨头软骨下不全骨折的有效手术选择。
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.Questions/purposes 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.