Subtrochanteric valgus osteotomy in developmental coxa vara

Abstract

Background: Valgus subtrochanteric osteotomy is the gold standard surgical treatment of developmental coxa vara. Nevertheless, there has been no consensus on the method of fixation and osteotomy details. In the literature, there are few reports on employing rigid internal fixation methods that preclude the need of postoperative immobilization. We present early radiologic and clinical outcome of a modified Y shaped subtrochanteric valgus osteotomy fixed with precontoured DCP.

Patients and Methods: Ten patients with 10 hips of developmental coxa vara were subjected to a corrective Y-shaped subtrochanteric valgus femoral osteotomy. All the cases were fixed by a precontoured small dynamic compression plate (DCP). There were six males and four females. The right hip was affected in four patients and the left hip in six. The average age at the presentation time was 5.1 years (range 4–9 years). Clinical evaluation was done by IOWA hip score.

Results: Clinically, the IOWA hip score improved postoperatively significantly (P<.05). The average preoperative head shaft angle was 94° (range 85°–100°) and the average post-operative head shaft angle was 120° (range 115°–125°). Postoperatively, the average epiphyseal-Hilgenreiner angle and the head-shaft angle fell into the normal values. No recurrence of deformity was reported.

Conclusion: The Y-shaped subtrochanteric valgus osteotomy with rigid internal fixation precludes the use of external immobilization attained satisfactory clinical and radiologic results with no evidence of deformity recurrence on the short-term follow-up.