[Transtrochanteric rotational osteotomy for idiopathic avascular necrosis of the femoral head (author's transl)].

Sugioka's transtrochanteric rotational osteotomy has turned out to be a new approach to the treatment of avascular necrosis of the femoral head in adults. It permits to displace necrotic bone outside the load area, as the rotation is performed in a range of 90 degree. Due to the anatomy of the pesterior region of the hip and the operative technique which takes special care of blood supply of the femoral head, vascular lesion, though quite conceivable because of the excessive rotation, does not occur. Sugioka's osteosynthesis by crossed screws has been performed successfully in Japanese. It cannot be recommended for surgery in white race people because of essentially different proportions of the length of extremities. So it does not provide early mobilisation and load bearing of white people treated in that way. This paper presents an essential modification on Sugioka's osteotomy. It modifies both the method of osteotomy and the osteosynthesis using a specially designed instrument. This modification eliminates the disadvantage of the originally described osteosynthesis, seems to improve blood supply of the rotated femoral head and facilitates the surgical procedure as well.