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The aim of this article is to present some long-term clinical and radiological results of valgus intertrochanteric osteotomy, as well as a literature review on this issue.īetween 19, we performed valgus intertrochanteric osteotomy (VITO) in six patients for partial ANFH after fracture of the femoral neck. Moreover, a number of important facts have been neglected there. Although this method is mentioned quite frequently, there are only a few studies in the literature dealing with it in detail, mostly in the form of case reports, with the follow-up period not exceeding seven years. One of these methods is intertrochanteric osteotomy (ITO) based on the principle of reorientation of the necrotic segment of the femoral head away from the weight-bearing zone of the hip joint. The published studies describe multiple methods of its treatment, ranging from core decompression up to total hip replacement.

The most severe of these is avascular necrosis of the femoral head (ANFH). VITO can improve the long-term function of the hip joint in adolescents with ANFH after a femoral neck fracture, but cannot restore completely the original shape and structure of the femoral head.įemoral neck fractures in children and adolescents are rare injuries, often associated with a number of complications. Subsequently, the patient developed severe osteoarthritis with marked clinical symptoms. In one patient, remodeling of the femoral head occurred during the first 6 years postoperatively. However, two patients gradually developed slight osteoarthritic changes. ResultsĬomparison of radiographs and MRI scans before and after VITO showed resorption of the necrotic segment of the femoral head and its remodeling in all five patients. The studied parameters included resorption of necrotic segment of femoral head, development of posttraumatic osteoarthritis and leg shortening. The mean age of the patients at the time of injury was 13.6 years and at the time of VITO 16.7 years. MethodsĪuthors evaluated five patients at the interval of 15 to 20 years following VITO. Although this method is mentioned in literature frequently, there are only few studies in the literature dealing with it in detail. The study evaluates long-term results in patients treated by valgus intertrochanteric osteotomy (VITO) for partial avascular necrosis of the femoral head (ANFH) after fracture of the femoral neck in adolescent age.