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The transtrochanteric rotation osteotomy described by Sugioka will preserve the femoral head in patients with avascular necrosis of the femoral head, but there is controversy about the clinical results. We developed a simulation system for rotation osteotomy, based on stereographic processing through computed tomography, the object being to determine the indication for this procedure and the degree of rotation required. This method makes it possible to determine the degree of rotation needed to displace the necrotic areas from the weightbearing zone; the need for a varus osteotomy can also be assessed. Our clinical results improved when we used this method. CT stereographic drawings in patients with avascular necrosis of the femoral head are useful for assessing the necrotic area.

Simulation by stereographic processing of computed tomography for transtrochanteric rotation osteotomy in necrosis of the femoral head