Surgical correction of infantile coxa vara

ABSTRACT

Surgical correction of infantile coxa vara can be achieved through valgus osteotomies, but recurrence ranges from 30-70%. Several previous studies have concluded that the single most important factor preventing recurrence of the deformity following surgical correction is to achieve an Epiphyseal-Hilgenreiner angle, [EHA] of 35-40°. This study evaluates the outcome of surgical correction of infantile coxa vara using an intertrochanteric Y-shaped valgus osteotomy. Eight children [nine hips] underwent an intertrochanteric Y-shaped valgus osteotomy for correction of infantile coxa vara. The age at time of surgery ranged from 4-8 years [average 5.4 years]. All hips had improvement of the immediate and final follow up EH A. In eight hips the EH A was corrected to hips had a recurrence of the deformity. This study describes a modification of the original Pauwels osteotomy by using a rigid method of internal fixation that is very useful for children from distant areas and with non compliant parents. It also emphasizes the recommendation of previous authors regarding correction of the EH A to 35-40° as a reliable method to avoid recurrence