Tooke S M, Amstutz H C, Hedley A K
Division of Orthopaedic Surgery, UCLA School of Medicine 90024.
Clin Orthop Relat Res. 1987 Nov(224):150-7.
Eighteen transtrochanteric rotational osteotomies have been performed in 17 patients for femoral head osteonecrosis (15 patients, Ficat Stage III disease; three patients, Ficat Stage IV disease) during a 51-month period and have 18 to 63 months of follow-up study. The best results were in the posttraumatic and nonsteroid-associated idiopathic cases in patients with small necrotic segments in the weight-bearing region, with no degenerative changes. Failures occurred in patients with large necrotic fragments, preexisting degenerative changes, and steroid- and alcohol-associated etiologies. Although joint arthroplasty was eventually required in ten hips, a period of temporization was achieved sufficient to bring them into the era of cementless hip arthroplasties. Indications for this operation should be restricted to those patients under 40 years of age with late Ficat Stage II or Stage III disease, in which the articular involvement in the lateral roentgenogram is 50% or less.
在51个月的时间里，对17例股骨头坏死患者实施了18例经转子旋转截骨术（15例Ficat III期疾病患者；3例Ficat IV期疾病患者），并进行了18至63个月的随访研究。最佳结果出现在创伤后和非甾体类药物相关的特发性病例中，这些患者负重区坏死节段较小，且无退行性改变。失败发生在坏死碎片较大、存在退行性改变以及与类固醇和酒精相关病因的患者中。尽管最终有10个股关节需要进行关节置换，但实现了一段足够长的临时缓解期，使这些患者进入了非骨水泥髋关节置换时代。该手术的适应证应限于40岁以下、Ficat II期或III期晚期疾病的患者，其中外侧X线片上关节受累面积为50%或更小。
