Intertrochanteric valgus osteotomy for post-traumatic coxa vara after proximal femur fractures

Abstract

To investigate the clinical effects of a new intertrochanteric valgus osteotomy technique designed by the authors for treatment of post-traumatic coxa varus after proximal femur fractures. Retrospectively analyzed 11 patients who developed coxa vara after sustaining proximal femoral fractures were treated with intertrochanteric valgus osteotomy from December 2005 to December 2018 in our hospital. This study included 6 cases of intertrochanteric fracture deformity union, 3 cases of subtrochanteric fracture nonunion and 2 cases of femoral neck fracture nonunion. Measured the degree of coxa varus, the differences in the lower limb length and force line in all patients. Evaluated hip function with the Harris hip score. All injuries were treated with the authors’ intertrochanteric valgus osteotomy technique. The average follow-up period was 3 years and evaluated the clinical effects by radiological examination and the Harris hip score. The average neck–shaft angle increased 35.0° (99.1°–134.1°) and the average limb shortening lengthened 1.9 cm (2.9–1.0 cm) after surgery. The average operating time was 67.2 minutes and blood loss was 237.7 ml. The osteotomy position healed in all patients 3 months later. Union of the 2 old femoral neck fractures was achieved 4 and 6 months after surgery, respectively, and no femoral head necrosis occurred during follow-up. The Harris hip score increased an average of 49 points (44.1–93.1 points) at 1 year postoperatively. Our self-designed intertrochanteric valgus osteotomy technique showed a favorable clinical effect to treatment coxa vara and can be used in the clinical setting.

Comparative Study on the Outcome of Pauwells Osteotomy and Total Hip Replacement in Neglected Fracture Neck of Femur in Young Adults

“…Limping and limb length discrepancy accounted for a less score. Tian S et al 18 have showed improvement in Harris Hip score upto 93.1 and Magu et al 6 showed average of 86.7. In THR, the average Harris hip score was 84.135± 8.87 which was not statistically significant indicating that irrespective of the nature of surgery, there is definitive improvement of hip function post operatively.…”

The impacts on the locomotor system triggered by the coxa valga and coxa vara pathologies: an integrative review

“…(Palmer et al, 2021). Na coxa vara é frequente as queixas de dores crônicas no quadril, desproporção do comprimento dos membros inferiores, fraqueza do glúteo, claudicação e limitação do movimento de abdução do quadril, sintomas e sinais que afetam significativamente a qualidade de vida dos portadores dessa condição (Tian et al, 2021).…”