Braunstein E M, Weissman B N, Sosman J L, Drew M
Skeletal Radiol. 1983;10(4):258-61. doi: 10.1007/BF00357901.
Intertrochanteric anterior rotational osteotomy is a recently developed surgical procedure to treat osteonecrosis of the femoral head. We reviewed the radiographic findings in four cases to acquaint radiologists with the usual appearance of the procedure and to assess surgical complications. In all cases, immediate postoperative radiographs showed rotation of the necrotic portion of the femoral head anteriorly so that it was no longer weight-bearing. Clinical and radiologic follow-up ranged from 12 to 30 months. In this time, three patients developed complications, including non-union of the osteotomy, further osteonecrosis with collapse of the femoral head, and worsening pain in the absence of progressive radiologic change. Radiology provides an important means of assessing rotational osteotomy, particularly in demonstrating sufficient rotation of the femoral head to assure nonweight-bearing by diseased bone. Also, surgical complications such as nonunion and hardware loosening may be identified. Nevertheless, the patient may deteriorate clinically even in the absence of radiologic demonstration of disease progression, and the absence of radiographic change does not assure a successful surgical outcome.
粗隆间前旋转截骨术是一种最近开发的用于治疗股骨头坏死的外科手术。我们回顾了4例患者的影像学表现，以使放射科医生熟悉该手术的常见表现，并评估手术并发症。在所有病例中，术后即刻X线片显示股骨头坏死部分向前旋转，使其不再负重。临床和影像学随访时间为12至30个月。在此期间，3例患者出现并发症，包括截骨不愈合、股骨头进一步坏死伴塌陷，以及在无进行性影像学改变的情况下疼痛加重。放射学是评估旋转截骨术的重要手段，特别是在显示股骨头充分旋转以确保病变骨不负重方面。此外，还可发现诸如不愈合和内固定松动等手术并发症。然而，即使在没有疾病进展的影像学证据的情况下，患者的临床症状也可能恶化，而且影像学无变化并不能保证手术结果成功。
