Proximal femoral osteotomies in children using the Richards hip screw: Techniques, outcome and subsequent removal

Webb, J.; Al-Maiyah, M.; McVie, James L.; Montgomery, Richard J.

doi:10.1007/s11832-008-0127-8

Cited by 11 publications

(11 citation statements)

References 33 publications

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“…This zero revision rate compares favourably with both older and newer systems such as the Richards intermediate hip screw, the AO blade plate and the Pediatric LCP Plate [ 7 , 8 , 10 , 11 ]. In addition, older systems were more likely to be followed by hip spica casting, which has high costs in terms of time and materials, is inconvenient for families and is associated with significant morbidity [ 8 , 10 , 17 , 18 , 21 , 22 ]. The LCP system also employs a locking screw technology but there are significant restrictions on the choice of NSA, given that most commercial systems have only two side-plate angles for varus correction [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Cannulated, locking blade plates for proximal femoral osteotomy in children and adolescents

Zhou

Camp

Gahukamble

et al. 2015

Journal of Children's Orthopaedics

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BackgroundProximal femoral osteotomy is the most common major reconstructive surgery in the region of the hip joint in children and adolescents. Given that it may be required across a wide range of ages and indications, appropriate instrumentation is necessary to ensure a technically satisfactory result. Recent developments in fixation include cannulation of the blade plate and locking screw technology.MethodsWe conducted a prospective audit of our first 25 patients who had a unilateral or bilateral proximal femoral osteotomy using a recently available system which combines cannulation and locking plate technology. The principal outcome measures were the radiographic position of the osteotomy at the time of union and surgical adverse events.ResultsForty-five proximal femoral osteotomies were performed in 25 patients, mean age 8 years (range 3–17 years), for a variety of indications, the most common of which was hip subluxation in children with cerebral palsy. All osteotomies were soundly united by 6 weeks in children and by 3 months in adolescents, in the position achieved intra-operatively. There were no revision procedures and the technical goals of surgery were achieved in all patients. There was one adverse event, a low-grade peri-prosthetic infection, diagnosed at the time of implant removal.ConclusionsIn this prospective audit of our first 25 patients, the new system performed well across a wide range of ages, body weights and surgical indications. Further comparative studies will be required to determine whether it offers additional advantages over more traditional systems.

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Section: Discussionmentioning

confidence: 99%

Cannulated, locking blade plates for proximal femoral osteotomy in children and adolescents

Zhou

Camp

Gahukamble

et al. 2015

Journal of Children's Orthopaedics

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“…The barrel plate junction in a sliding hip screw is devoid of any such threads and is smooth to ensure gliding of screw within the barrel for controlled collapse. To the best of our knowledge there has been only one reported case in a series of pediatric proximal femoral osteotomies where this complication was encountered [23]. The technique described here is simple and should be attempted before resorting to other complicated methods.…”

Section: Discussionmentioning

confidence: 86%

Case Report: Cold welding of barrel plate to Richard screw: an unusual complication witnessed during sliding hip screw removal.

Sreenivasan¹,

Chahar²,

Verma³

et al. 2016

Prog Orthop Sci

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Implant removal is one of the most common procedures performed in orthopaedics. More often than not, it is more difficult than the index operation to insert the implant. The Sliding Hip Screw (SHS) is one of the most commonly used devices for the fixation of intertrochanteric fractures. The screw and barrel are designed to allow for smooth gliding. Titanium implants are often associated with the complication of cold welding. Stainless steel implants are less commonly associated with this phenomenon. We report an unusual case of cold welding of the barrel and Richard screw encountered during the removal of a stainless steel sliding hip screw construct in a routine case of peri-implant fracture in an 80 year old female who had sustained household trauma due to a slip.

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“…Of these, a loss of fixation, wound problems, hardware prominence, loosening and femur fracture are the most important. 5,8 The LCP plate has a low lateral profile that avoids the problem of prominent metal seen in the blade plate. 5 Moreover, it has a low risk of disturbances to periosteal blood supply due to the low bone-plate contact while using locking screws.…”

Section: Discussionmentioning

confidence: 99%

“…Different complications have been raised in the literature following inter-and subtrochanteric PFOs, such as metal cut out, loss of correction, wound infection, hematoma formation, femur neck fractures, heterotopic ossification and metal breakage. [5][6][7] The locking pediatric hip plate system has been shown to have an improvement in the fixation strength and stability through the use of locking screws, in addition to a decrease in the loosening rate in weak osteoporotic bones. 3,6 At our university hospital, the LCP pediatric hip plate (DePuy Synthes -Oberdorf Switzerland) has been used since late 2011.…”

Section: Introductionmentioning

confidence: 99%

<p>Safety of the LCP Pediatric Hip Plate in Proximal Femoral Osteotomy in Children with Cerebral Palsy</p>

Samarah¹,

Shaheen²,

Tehabsim³

et al. 2020

JMDH

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Proximal femoral osteotomy in cerebral palsy patients is a demanding procedure. The fixation of the osteotomy can fail due to the weak osteoporotic bone. The LCP pediatric hip plate with its good grip makes these procedures safe. The aims of the present study are to evaluate the radiological outcome of proximal femoral osteotomy that was fixed with the pediatric LCP in cerebral palsy patients and to raise safety issues regarding its low rate of complications. Patients and Methods: Sixteen patients with cerebral palsy who were operated in our department were included in this retrospective study. Data collected from medical charts and X-ray measurements retrospectively reviewed. Results: In total, 16 patients (21 hips), ie, 9 males and 7 females, were included in this analysis. The mean age at the time of the index surgery was 11.9 years (5.9-18.0). The mean follow-up period was 4.78 years (1.5-8.0). Five patients had bilateral hip involvement and 11 had unilateral involvement. All patients had spastic cerebral palsy. The mean values of varus correction and de-rotation were 25° (0°-45°) and 35° (20°-50°), respectively. Neck shaft angle and the Reimer's migration index were significantly improved postoperatively (p<0.01 for both). Seventeen hips showed complete consolidation within 14 weeks of fixation and four hips needed 16 weeks. These four hips were in three patients who were 16 years of age or older. The correlation between age at surgery and the time needed for consolidation was statistically significant (p=0.005). Avascular necrosis, revision surgeries, failure of fixation, acetabular penetration, screw loosening or fracture of the femur were not seen in this study. Conclusion: The LCP pediatric hip plate can be used safely in CP patients. The plate provides a strong stable fixation on osteoporotic bone with a low rate of complications.

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Proximal femoral osteotomies in children using the Richards hip screw: Techniques, outcome and subsequent removal

Cited by 11 publications

References 33 publications

Cannulated, locking blade plates for proximal femoral osteotomy in children and adolescents

Cannulated, locking blade plates for proximal femoral osteotomy in children and adolescents

Case Report: Cold welding of barrel plate to Richard screw: an unusual complication witnessed during sliding hip screw removal.

<p>Safety of the LCP Pediatric Hip Plate in Proximal Femoral Osteotomy in Children with Cerebral Palsy</p>

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