Transtrochanteric rotational osteotomy for osteonecrosis of the femoral head with preoperative superselective angiography

A prospective radiologic and scintigraphic study was made of 15 joints in 12 patients who underwent transtrochanteric rotational osteotomy of the femoral head after identifying by preoperative superselective angiography which arteries should be preserved during surgery. The preoperative superselecti...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2000, Vol.120 (7-8), p.437-440
Main Authors: YASUNAGA, Y, IKUTA, Y, OMOTO, O, SHIGENOBU, T, ITOH, K, FUKUOKA, H, NAITOH, A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Angiography
Biological and medical sciences
Female
Femoral Artery - diagnostic imaging
Femur Head - blood supply
Femur Head - surgery
Femur Head Necrosis - diagnostic imaging
Femur Head Necrosis - surgery
Humans
Iliac Artery - diagnostic imaging
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical imaging
Medical sciences
Middle Aged
Osteoarticular system. Muscles
Osteotomy - methods
Postoperative Complications - diagnostic imaging
Prospective Studies
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Regional Blood Flow - physiology
Surgery
Veins & arteries
Weight-Bearing - physiology
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Summary:A prospective radiologic and scintigraphic study was made of 15 joints in 12 patients who underwent transtrochanteric rotational osteotomy of the femoral head after identifying by preoperative superselective angiography which arteries should be preserved during surgery. The preoperative superselective angiography revealed that the blood supply to the femoral head was provided by the medial femoral circumflex artery in 12 joints and a branch of the internal iliac artery in 3 joints. These nutrient arteries were preserved during surgery. At the follow-up examination made after at least 2 years, there were no cases of collapse of the new femoral head weight-bearing site, and also there were no cases with a large cold area in the femoral head on the scintigram obtained 2 months postoperatively. For this operative procedure, the nutrient arteries of the femoral head should be confirmed by preoperative superselective angiography, and it is essential that these arteries be preserved during surgery.
ISSN:0936-8051
1434-3916
DOI:10.1007/s004029900130