Incidence and risk factors of hardware-related complications after proximal femoral osteotomy in children and adolescents

Abstract

Therapeutic Level III.

Risk factors for implant-related fractures after proximal femoral osteotomy in children with developmental dysplasia of the hip: a case-control study

“…For the children in the fracture group, the average time from osteotomy to fracture was 12 months (2.2-25 months). It was 9.6 months (2.2-24 months) for the children with implants remaining and 15 months (8.7-25) for the children who of implant-related fractures has been reported to be 0.3-3.6% by other authors (Jain et al 2016, Chung et al 2018 and was 1.9% (27/1,385) in our study. The rate varied by location and disease.…”

“…No clear definitions of implant-related fractures exist; generally, these fractures include peri-implant fractures that occur within 6 months after hardware removal without trauma (Busam et al 2006, Chung et al 2018. The occurrence rate no differences in the time from osteotomy to fracture between the children immobilized by an orthosis and those immobilized by a cast ( Figure 4D).…”

“…Multiple analyses of risk factors for implant-related fractures were evaluated by logistic regression, and odds ratios (ORs) with their 95% confidence intervals (CIs) were also obtained. The potential risk factors included in the multiple analyses were the type of PFO, factors considered in previous studies (types of implant, implant removal status) (Jain et al 2012, Chung et al 2018…”

“…Although the rate is low, these complications or fractures prolong immobilization in children and sometimes require additional surgery. Few studies have investigated relations between implant-related fractures and sites of fractures or types of plates (Becker et al 2012, Jain et al 2012, Chung et al 2018. Jain et al (2012) reported that the femur is more likely to incur an implant-related fracture than are other bones, and suggested that the level of stress exerted by an implant can be high over short anatomic distances in the proximal femur.…”

Orthopaedic Fixation Devices Used in Children: A Radiologist's Guide

“…Proximal femoral osteotomy is used to correct deformities that result from a variety of hip diseases that can affect children and adolescents such as cerebral palsy, hip dysplasia, idiopathic femoral anteversion, and Legg-Calvé-Perthes disease. 34 Two of the most commonly used fixation devices for stabilizing the osteotomy and achieving optimal alignment are the fixed-angle blade plate and the hip plate. [34][35][36] When a cannulated blade plate is used, a chisel is passed over a guidewire and driven into the center of the femoral neck while the flat end of the plate is affixed to the proximal femoral diaphysis with screws 35 (►Fig.…”