Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Coxa Vara”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1997

Valgus osteotomy for congenital coxa vara.

Congenital coxa vara is a rare disease which can result in a significant disability if untreated or improperly treated. In this retrospective review of eight patients (12 hips) with congenital coxa vara, there were five boys and three girls. Four patients had bilateral involvement and four had unilateral involvement. At the time of surgery, the average age was 7.9 years. All patients underwent valgus intertrochanteric osteotomy with wires or blade-plates for fixation. The mean Hilgenreiner-epiphyseal angle was 75 degrees before surgery and improved to 25 degrees after surgery. The mean neck-shaft angle improved from 95 degrees to 137 degrees immediately after the osteotomies and was 125 degrees at the final follow-up. At a minimum two year follow-up only three hips in three patients maintained more than 80% correction. These three patients all had developmental coxa vara. The acetabular depth improved significantly in the patients with developmental coxa vara, especially in two patients (three hips) who underwent surgery before 6 years of age. Closure of physeal plates was found in three patients (five hips) before surgery and occurred in two patients (two hips) after surgery. After surgery, only two patients had persistent soreness. One patient walked with a limp, and the other, with multiple epiphyseal dysplasia had significant leg length discrepancy. Our results show that valgus osteotomy can correct varus deformities of the proximal femur and improve function. If performed early, it can also prevent the development of hip dysplasia in patients with developmental coxa vara. However, the response of acetabular development was variable in patients with coxa vara due to skeletal dysplasia, despite valgus osteotomy.

Adolescent↗
PubMed1980

Infantile coxa vara.

Infantile coxa vara is an unusual localized dysplasia, not evident at birth, which is first noticed when the child begins walking. Twelve cases are presented with emphasis on the characteristic roentgen findings which include abnormal ossification of the femoral neck, a vertical physis, a characteristic triangular osseous fragment at the medial inferior corner of the metaphysis, and a straight femoral shaft. Prompt diagnosis and early management can reduce severe deformity and degenerative changes of the hip. For this reason, infantile coxa vara must be differentiated from other generalized and localized causes of coxa vara, including congenital dysplasias and acquired abnormalities.

Child↗
PubMed2003

Stress fractures of the femoral neck and coxa vara.

BACKGROUND: Theoretically, coxa vara substantially modifies the biomechanical conditions of the femoral neck, increasing the effect of direct muscle pull and leading to fatigue of opposing muscle groups; such modifications would appear to favour the appearance of stress fractures. METHODS: We studied 22 stress fractures of the femoral neck, 12 in patients with coxa vara (group A) and 10 in patients with a normal neck-shaft angle (group B), to assess the possible influence of the femoral angle in the production of stress fractures. RESULTS: Intergroup differences were found for age at the appearance of the fracture (younger patients in the coxa vara group) and symptom duration (longer in group A). CONCLUSIONS: It is suggested that coxa vara predisposes to femoral neck stress-fracture.

Aged↗
PubMedDate not supplied

Coxa vara in childhood: evaluation and management.

Coxa vara in childhood may be clinically classified as developmental, congenital, dysplastic, or traumatic and may occur at the physis or in the trochanteric or subtrochanteric area. Evaluation should include a search for a family history of similar deformity, a history of trauma or infection, and evidence of associated skeletal abnormality. Radiographs will illustrate whether the deformity is unilateral or bilateral and whether it occurs at or below the physis. With this information, coxa vara can be classified, and the optimal treatment can be selected. Surgical treatment of coxa vara in childhood is usually indicated when the disease is progressive, painful, unilateral, or associated with leg-length discrepancy.

Bone Diseases↗
PubMed2006

Coxa vara: a novel measurement technique in skeletal dysplasias.

Coxa vara can be a progressive deformity in children with skeletal dysplasia. Preoperative anteroposterior pelvic radiographs of 30 children with spondyloepiphyseal dysplasia congenita and spondyloepimetaphyseal dysplasia were used to test the reliability of a new radiographic measure of coxa vara, the Hilgenreiner-trochanteric angle. An additional 10 patients (20 hips) with coxa vara deformities needing valgus-producing proximal femoral osteotomies also were reviewed. Interobserver reliability with plain radiographs was 0.929 for the left side and 0.914 for the right side using interclass correlation coefficients. Intraobserver reliability also was high, with an interclass correlation coefficient of 0.875. Twelve hips corrected by osteotomy had adequate ossification to measure the Hilgenreiner-epiphyseal angle, head-shaft angle, and Hilgenreiner-trochanteric angle. Only one of these hips had a recurrence. The results were good in all of the other ossified hips. Eight hips had limited ossification; only two of these hips maintained acceptable alignment. Six hips had less postoperative correction and progressive deformity at the final followup. We present a novel measurement technique to determine the degree of coxa vara deformity in children with delayed or absent ossification of the capital femoral epiphysis.

Adolescent↗
PubMed1990

The treatment of infantile coxa vara with the external circular fixator.

Coxa vara worsens as it evolves, and is often accompanied by other femoral deformities, such as hypometria, axial knee deviations, and rotational deformity. Traditional surgical techniques, especially intracapsular femoral neck osteotomy, are difficult to execute and often cause joint stiffness while not sufficiently correcting the coxa vara or the other deformities, in particular hypometria. For these reasons this study used the external circular fixator to simultaneously correct these deformities. The results are presented after discussion of technical details.

Bone Diseases, Developmental↗
PubMed1992

[Coxa vara in children. Apropos of 28 cases].

Infantile coxa-vara is an infrequent lesion and two etiologic factors have been recognised: mechanical and genetic. As in Blount's disease, the same populations (black and scandinavian people) are usually affected. Twenty eight patients with 42 infantile coxa vara were reviewed. The diagnosis was often late. The radiographs showed the decrease of the neck-shaft angle and the signs of cervical dystrophy. The aggravation of the coxa vara is usual and pseudarthrosis or osteo-arthritis can be observed. Thirty six femoral valgus sub-trochanteric osteotomies were done. The results were best when the surgery was done before the age of 9 years. When the surgery was done later, an epiphysiodesis of the greater trochanter was associated to the femoral osteotomy if the epiphyseal cartilage was fused. Langenskiold's osteotomy was used only when the neck-shaft angle was lower than 80 degrees. The results were evaluated according to the neck shaft angle and the morphology of the femoral head: 22 very good and good, 11 fair and 3 bad results were noted.

Adolescent↗
PubMedDate not supplied

High prevalence of coxa vara in patients with severe osteogenesis imperfecta.

The purpose of this study was to determine the incidence and clinical presentation of coxa vara in 283 patients with osteogenesis imperfecta (OI). The charts and X-rays of 150 girls and 133 boys with OI were reviewed. The patients were classified according to the Sillence classification modified by Glorieux: 94 type I, 90 type IV, 67 type III, 18 type V, 10 type VI, and 4 type VII. The mean age was 9.4 years (range 0.3-23.3). Twenty-nine patients (10.2%) had coxa vara (23 left and 20 right). Fifty-five percent of them were type III, 24% type IV, 13.8% type VI, and 3.4% each of types V and VII. The incidence of coxa vara was 6% in type V, 8% in type IV, 24% in type III, 25% in type VII, and 40% in type VI (P < 0.001 for difference between types I, III, and IV). The mean neck-shaft angle was 99 degrees (range 80-110 degrees), the average head-shaft angle was 104 degrees (range 90-120 degrees), and the mean Hilgenreiner-epiphyseal angle was 68 degrees (range 40-90 degrees). Twenty-five patients (36 hips) had previous femoral rodding before diagnosis and seven hips (all type III) had no history of rodding. Abduction and internal rotation of the hip joints were restricted in all patients with this deformity. All children with coxa vara had a Trendelenburg gait. In conclusion, coxa vara in OI is not rare, especially in severe forms of the disease. Regular clinical and radiologic follow-up is indicated in children with previous femoral rodding and in severely affected children, particularly those with OI type III.

Adolescent↗
PubMedDate not supplied

Coxa vara: surgical outcomes of valgus osteotomies.

Since the 1950s, valgus-producing femoral osteotomy has been the preferred treatment for significant coxa vara. Despite well-performed surgeries, the literature cites recurrence rates of 30-70%. The present study reviews our past 15 years of surgical experience for coxa vara; 26 children with 37 affected hips were retrospectively evaluated for outcome following valgus osteotomy. Both congenital and acquired types of coxa vara were included. Overall recurrence rate following valgus osteotomy was 50%. Age at time of surgery, type of surgery, and type of implant and etiology were found to have no bearing on recurrence. However, if Hilgenreiner's epiphyseal angle was corrected to < 38 degrees, 95% of children had no recurrence of varus. In contrast, head-shaft angle was found not to be a reliable indicator of appropriate correction. Only six of 37 hips required pelvic osteotomy (five Pemberton, one Chiari) for dysplasia, and four of these had developmental dysplasia of the hip as the underlying etiology for their coxa vara. However, if the proximal femur was corrected and maintained before age 10, 83% of children had excellent acetabular depth, spherical congruency, relief from pain, and correction of Trendelenburg gait at latest follow-up.

Child↗
PubMedDate not supplied

Percutaneous triplanar femoral osteotomy correction for developmental coxa vara: a new technique.

Developmental coxa vara (DCV) is a well-known pediatric hip disorder that is associated with triplanar deformity of the proximal femur. Several techniques of proximal femur osteotomies have being cited in the literature, with variable outcomes. Recently, the authors have used a percutaneous technique with application of a low-profile Ilizarov external fixator for acute opening wedge correction of the femoral deformity associated with DCV. Five children (six affected hips) underwent the above procedure at an average age of 8 + 4 years. The average improvement in Hilgenreiner's epiphyseal angle was from 74 degrees before surgery to 33 degrees after surgery, the neck-shaft angle improved from 86 degrees to 137 degrees, and the articulo-trochanteric distance improved from -6 mm to +11 mm. Latest follow-up at a mean of 2.1 years after surgery showed satisfactory healing with no significant loss of correction in any case. This percutaneous technique offers several advantages over currently available methods for surgical correction of DCV.

Bone Diseases, Developmental↗
PubMed2001

Coxa vara: another option for fixation.

Coxa vara is a progressive childhood deformity that is best remedied by a valgus intertrochanteric osteotomy. By restoring the femoral neck and its physis to a more anatomic position, hip mechanics are normalized, with consequent beneficial effects upon hip motion, limb lengths and acetabular development. In the pediatric age group, there is no implant specifically designed for this purpose. Therefore, in addition to the challenge of obtaining adequate correction, inadequate fixation may contribute to recurrent varus deformity, a problem that, according to the literature, has a 30% to 70% prevalence. We are presenting a new technique using a modified veterinary plate for osteosynthesis in children in the 5-year-old to 11-year-old age group. The rationale, implant design, surgical technique and results in a group of nine patients (12 hips) are described.

Bone Plates↗