Femoral remodelling after subtrochanteric osteotomy for developmental dysplasia of the hip

The Journal of Bone and Joint Surgery. British Volume
S M SangaviM K Benson

Abstract

Children who present late with hip dislocation may require femoral osteotomy after reduction, to correct valgus and anteversion deformity of the femoral neck. After these procedures proximal femoral growth is unpredictable. We have studied proximal femoral growth in 40 children who had been treated by femoral osteotomy. Preoperatively, the mean femoral neck-shaft angle was 5 degrees greater on the affected side than on the contralateral side. Postoperatively, it was 28 degrees less. There was progressive recorrection; after five years the angle was not significantly different from that on the contralateral side. In our series 70% of the capital epiphyses became abnormally shaped, taking the appearance of a 'jockey's cap'. All the growth plates became angulated but this corrected with time. Correction of the neck-shaft angle probably results from the more normal mechanical environment provided by reduction. The abnormal radiographic appearance of the epiphysis and growth plate is probably due to the rotation produced by the osteotomy.

Citations

Jun 4, 1998·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·P GarneroP D Delmas
Mar 25, 2009·Journal of Children's Orthopaedics·Alexandre ArkaderRomildo Merçon Amorim
Nov 1, 2007·Journal of Children's Orthopaedics·Hüseyin ArslanSerdar Necmioğlu
Dec 12, 2001·ANZ Journal of Surgery·A J WilkinsonH K Graham

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