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The place of intertrochanteric osteotomy in the treatment of idiopathic necrosis of the head of the femur

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Summary

The authors present their experience of the use of intertrochanteric osteotomy for the treatment of idiopathic necrosis of the head of the femur. The results obtained from 102 osteotomies performed on 81 patients with the disease are analysed. The mean follow-up is 4.2 years. The results show a statistically significant clinical improvement after operation. Patients presenting with Ficat and Arlet Stage II involvement fared much better than those with more severe changes. Better results were also seen in those with a necrosis angle of less than 200°. No radiological improvement was seen although a high percentage showed no deterioration.

The choice of treatment for the condition is discussed in the light of these results.

Résumé

Les auteurs présentent leur expérience de l'ostéotomie intertrochantérienne dans le traitement de la nécrose idiopathique de la tête fémorale. Ils analysent les résultats obtenus dans 102 ostéotomies, pratiquées sur 81 malades, avec un recul de 4.1 ans. Une amélioration clinique statistiquement significative a été observée après l'opération, spécialement dans les cas vus au stade II de Ficat et Arlet (91% des malades sont satisfaits). L'influence de l'angle de nécrose est également démontrée, les meilleurs résultats ayant été obtenus lorsque cet angle est inférieur à 200°. Il n'y a pas d'amélioration radiologique, mais une stabilisation de l'évolution dans un grand nombre de cas. A la lumière des résultats obtenus, les auteurs exposent leurs indications thérapeutiques dans le traitement de l'ostéonécrose de la tête fémorale.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, University Clinic of Navarra, 31008, Pamplona, Spain

    J. Cañadell, L. Aguilella, J.R Azcárate & J. R. Valenti

Authors
  1. J. Cañadell
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  2. L. Aguilella
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  3. J.R Azcárate
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  4. J. R. Valenti
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Cañadell, J., Aguilella, L., Azcárate, J. et al. The place of intertrochanteric osteotomy in the treatment of idiopathic necrosis of the head of the femur. International Orthopaedics 10, 41–46 (1986). https://doi.org/10.1007/BF00266271

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