No abstract available.
Coxa Vara* ; Follow-Up Studies*

Developmental coxa vara is a rare disease and the symptoms do not appear at birth, but rather, they appear at the age of walking. Clinically, the symptoms include a waddling gait, limb length discrepancy and frequent weariness. Developmental coxa vara is sometimes associated with skeletal dysplasia. Especially, it is associated with spondylometaphyseal dysplsia and the vertebral bodies and long bones are affected. The authors report here on diagnosing and treating this rare disease and we review the relevant literatures.
Coxa Vara ; Extremities ; Gait ; Hip ; Osteochondrodysplasias ; Parturition ; Rare Diseases ; Walking

PURPOSE: Single or multiple fibrous dysplasia of the proximal femur can cause coxa vara, Shepherd's crook deformity and a leg length discrepancy for those patients who require surgical treatment. We wanted to evaluate the efficiency of surgical treating fibrous dysplasia of the proximal femur. MATERIALS AND METHODS: Among the patients who underwent surgical treatment at our hospital during the period of June, 2001 to October, 2007, we selected 18 patients who underwent curettage and bone graft or valgus osteotomy and internal fixation due to proximal femur involvement. The clinical results were analyzed based on the patients' clinical records and radiologic findings. RESULTS: The group of patients with a normal neck-shaft angle (Group 1) could achieve satisfactory results by undergoing curettage, bone graft and internal fixation. The other group of patients who progressed to Shepherd's crook deformity (Group 2) could have satisfactory results when they underwent valgus osteotomy and soft tissue release or both proximal femur shortening osteotomy and valgus osteotomy, but not with undergoing valgus osteotomy only. CONCLUSION: Varus deformity in patients with fibrous dysplasia may progress even though they undergo valgus osteotomy. It is important to consider the preoperative biomechanical condition of the proximal femur before performing surgery.
Congenital Abnormalities ; Coxa Vara ; Curettage ; Femur ; Humans ; Leg ; Osteotomy ; Transplants

Congenital coxa vara is a rare congenital deformity seen in infancy and childhood and usually not discovered until walking is begun and characterized by a progressive decrease in the angle between the femoral neck and shaft and consequently by a progressive shortening of the limb and also by the presence of a defect in the medial part of the neck We have experienced a case of it treated with valgns osteotomy and the case review is presented.
Congenital Abnormalities ; Coxa Vara ; Extremities ; Femur Neck ; Neck ; Osteotomy ; Walking

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.
Congenital Abnormalities ; Coxa Valga ; Coxa Vara ; Follow-Up Studies ; Hip ; Leg ; Orthopedics ; Osteotomy

PURPOSE: To investigate the results of treatment of reverse oblique trochanteric fractures with compression hip screw. METHODS: We reviewed the results of 12 cases of reverse oblique trochanteric fracture treated with compression hip screw from January 2000 to December 2006 which could be followed up for more than 1 year. The mean follow up period was 26 months (15~40). The mean age was 48 years old. Injury mechanism was composed of 6 cases of traffic accident and 6 cases of fall down. 8 persons were man. We investigated the union time, degree of neck-shaft angle change, amount of sliding of compression hip screw, complications, functional and clinical results. RESULTS: 10 cases were united and the mean union time were 5 months (3~8). The mean neck-shaft angle change was 3.5 degrees (0~12). The amount of sliding of compression hip screw was 8.9 mm (2~24). There were six coxa vara, six leg due to coxa vara shortening, two nonunion, and one superficial infection. Unsatisfactory results of Jensen's social function score and Parker and Palmer's mobility score were studied. CONCLUSION: The results of treatment of reverse oblique trochanteric fractures with compression hip screw were relatively unsatisfied.
Accidents, Traffic ; Coxa Vara ; Femur ; Follow-Up Studies ; Hip ; Hip Fractures ; Humans ; Leg

Spondyloepiphyseal dysplasia congenita (SEDC) is a kind of skeletal dysplasia, inheritable condition. The clinical features of SEDC are dwarfism, myopia with or without retinal detachment, coxa vara, thoracic dysplasia with respiratory failure and laryngotracheal stenosis. A point of particular concern to anesthetists is odontoid hypoplasia which, combined with ligamentous laxity, leads to atlantoaxial instability. We report successful general anesthesia for cervical spine fusion of a patient with SEDC.
Anesthesia, General ; Constriction, Pathologic ; Coxa Vara ; Dwarfism ; Humans ; Ligaments ; Myopia ; Osteochondrodysplasias ; Respiratory Insufficiency ; Retinal Detachment ; Spine

PURPOSE: To determine the developmental patterns of 4 major deformities of femoral head commonly observed in Legg-Calve-Perthes disease (LCPD): coxa plana, coxa magna, coxa vara, subluxation. MATERIALS AND METHODS: We reviewed the clinical records and radiographs of 85 unilateral LCPD children who were followed up from the early stage of disease to full skeletal maturity. Four major deformities were measured and observed during 3 periods: the active disease stages of avascular necrosis and fragmentation, the healing stage, and skeletal maturity. RESULTS: All four deformities were first observed at early stages of the disease, avascular or fragmentation stage. Appearance rates were 79% in coxa plana, 28% in coxa magna, 35% in coxa vara, and 27% in subluxation. The gradual progression of deformities with time which was demonstrated at the healing stage and at skeletal maturity were observed in all except subluxation. And this gradual increase was supposed to be dependent on the normal bony growth with aging. CONCLUSION: We determined the developmental pattern of major deformities of the femoral head. And this determination will help to understand the natural course of deformity which is clinically important in terms of late osteoarthritis.
Aging ; Child ; Congenital Abnormalities* ; Coxa Vara ; Head* ; Hip ; Humans ; Legg-Calve-Perthes Disease* ; Necrosis ; Osteoarthritis

PURPOSE: The purpose of this study was to report the clinical result of subtrochanteric fractures which were treated with Rowe plate. MATERIALS AND METHODS: 30 cases of subtrochanteric fracture, which were operatively treated with Rowe plate, were evaluated clinically and radiographically. All patients were followed for at least 1 year. RESULTS: Primary bony union was achieved in 28 cases (93%) . Bony union after secondary operative procedure was obtained in 2 cases (6.7%) . The fracture was united within 6 months except 3 cases. As complications, coxa vara deformity under 120. of neck-shaft angle was observed in 2 cases and one of them was associated with limb shortening more than 1 cm. CONCLUSION: We could obtain satisfactory clinical results with the use of Rowe plate in treating some selected cases of subtrochanteric fracture. The good indications for the use of Rowe plate seem to be some subtrochanteric fracture associated with intertrochanteric fracture, long spiral subtrochanteric fracture, comminuted subtrochanteric fracture with multiple large fragment, and subtrochanteric fracture in deformed proximal femur.
Congenital Abnormalities ; Coxa Vara ; Extremities ; Femur ; Fractures, Comminuted ; Hip Fractures ; Humans ; Surgical Procedures, Operative

PURPOSE: To evaluate the treatment results of geriatric intertrochanteric fractures by using Asian-Pacific Gamma nails. MATERIALS AND METHODS: From June 1994 to June 1997, 58 cases of the intertrochanteric fractures were treated with Asian-Pacific Gamma nail, particularly compression hip screw fixation complications such as communited fracture involving lesser trochanter, transverse or reverse oblique intertrochanteric fracture. We evaluated the bone union time, neck-shaft angle, lag screw sliding by follow up radiographs, and studied complications and intraoperative cautions. RESULTS: The average age was 74.4 years old, the mean duration of follow-up was 17 months, the mean duration of bone union was 14.2 weeks, the average neck-shaft angle was postop. 133+/-2.78 degree and last follow-up was 129.5+/-3.37 degree, and the average lag screw sliding was 4.7+/-3.16 mm. Intraoperative complications were difficulty in distal drilling (posterior drilling) in 4 cases, fracture displacement by nail insertion in 3 cases, and postoperative complications were coxa vara in 13 cases, superior cutting out of lag screw with nonunion in 1 case and superficial infection in 1 case. The entry portal must be formed by awling. The fracture displacement when inserting nail could be prevented by proper reaming after inserting the C-shaped guide pin, and posterior drilling could be avoided by confirming the locking between target device and nail. CONCLUSIONS: We conclude that the Asian-Pacific Gamma nail could appropriately treat the osteoporotic, communited intertrochanteric fracture in elderly patients and we obtained satisfactory results.
Aged ; Coxa Vara ; Femur* ; Follow-Up Studies ; Hip ; Hip Fractures ; Humans ; Intraoperative Complications ; Postoperative Complications