J Korean Orthop Assoc.
1978 Jun;13(2):213-218. 10.4055/jkoa.1978.13.2.213.
Subtrochanteric Osteotomy in Congenital Coxa Vara Report of 3 Cases
- KMID: 2460385
- DOI: http://doi.org/10.4055/jkoa.1978.13.2.213
Abstract
- Three cases of congenital coxa vara were treated by subtroch-anterie abduction osteotomy with percutaneous pin fixation of both fragments. The indications of the corrective subtrochanteric osteotomy for coxa vara deformity were the neck-shaft angle of 100 degress or less, the presence of marked gluteus medius limp and the vertical neck defect with progression of the varus deformity. Through a lateral approach, the lateral aspect of the proximal end to the femoral shaft was exposed and 2 Steinmann pins were inserted through the upper and lower levels to the proposed osteotomy. The distal pin was inserted perpendicular to the long axis of the femur and the proximal pin at an algle of desired correction to the distal pin and a subtrochanteric transverse osteotomy was completed. Two Steinmann pins were paralell to each other by adducting the proximal fragment and abducting the distal fragment. and the lateral cortex of the proximal fragment was impacted into the marrow cavity of the distal fragment. The Steinmann pins were then incorporated in the hip spica cast. The object of the operation was to correct the coxa vara, to change the stress on the vertical fissure in the neck from shear to compression and to overcome shortening of leg. With this technically simple method, the authors achieved adequate correction of the deformity. The ostetomies healed rapidly and the medullary canal was re-established in all cases, The gait of each patient was markedly improved and the Trendelenburg test become negative in all of them. One of these patients showed a mild recurrence of varus deformity and limp 2 years following surgery.
