ABSTRACT
[Objective]To investigate Y-shaped osteotomy and the internal fixation with geese-head steel plates for treatment of congenital coxa vara.[Method]Lesser subtrochanteric and greater laterotrochanteric osteotomy were performed for 7 cases(9 hips)of congenital coxa vara with the Y-shaped osteotomy line.The distal femoral section met the lateral greater trochanteric section,fixed with geese-head steel plates.[Result]The cases were followed up for 1~5 years(averaged 3.6 years).According to Shi Yingqi's evaluation,4 hips were excellent,4 good and 1 fair.[Conclusion]The Y-shaped osteotomy and internal fixation with geese-head steel plates can improve the abnormal structure of upper femur,increase the real length of the affected limb.Therefore,it is an ideal effective method for treatment of congenital coxa vara.
ABSTRACT
In 5 cases of congenital coxa vara, 7 cases of acquired coxa vara and 4 hips in 3 cases of acquired coxa valga, we performed subtrochanteric osteotomies at Department of Orthopedic Surgery, SeoulNational University Hospital, from December 1980 to February 1984. At a relatively short interim follow-up, following observations were made on the correction of the femoral neck-shaft angle deformities. l. In the congenital coxa vara group, at an average follow-up of 1 year and 3 months, 97.9% of the correction obtained by osteotomy was maintained, based on the roentgenographic measurements of femoral neck-shaft angle. In the acquired coxa vara group, at an average follow-up of 1 year and 2 months, 93.3 % of the correction obtained by osteotomy was maintained. In the acquired coxa valga group, at an average follow-up of 1 year and 5 months, 92.9% of the correction obtained by osteotomy was maintained. 2. At final follow-up, leg length gain averaged 1.26cm in the congenital coxa vara group and 2.23cm in the acquired coxa vara group. An average 0.70cm decrease in leg length was noted in the acquired coxa valga group. 3. Trendelenburg sign, which was positive in all the cases of the congenital and acquired coxa vara group, reverted to negative in all. 4. Slight overcorrection in cases of the acquired coxa vara and undercorrection in cases of the acquired coxa valga, is recommended for later loss of surgically corrected femoral neck-shaft angle. In the congenital coxa vara, it appeared that loss of correction was relatively minor.