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

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

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

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

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

Many unsolved probIems still remain in these in management of trochanteric fracture of hip, especially unstable type of trochanteric fracture. Among many cases of the trochanteric fracture treated during period from Jan. 1963 to July, 1973 at Busan National University Hospital, six patient has severe sequelae such as coxa vara deformity, shortening of the affected limb and ankylosis of the hip joint, which were analyzed clinically and results obtained were as follow. 1. It is the most important factor that the medial and the posterior cortex is good alignment in reduction with internal fixation and maintainance of unstable trochanteric fracture. 2. It is dangerous for the unstable type of trochanteric fracture to be reducted and maintained with only screws or plates. Jewett nail is more effective than the S-P nail and Thornton plate in internal fixation of unstable type of trochanteric franture. 3. The posterior fragments can hardly be found in A-P view but easily in lateral view 4. In cases that had not good alignments between posterior fragments the distaI fragment displaced medially and migration of the naiI, distraction of the pIate, malunion have developed in spite of prolonged immobilization in cast. 5. In one case that the severe coxa vara deformity have been developed. we performed the transverse osteotomy & fixed with Blount-V-blade plate like device. The result was good but the shortening of the limb could not prevent.
Ankylosis ; Busan ; Congenital Abnormalities ; Coxa Vara ; Extremities ; Femur ; Hip Joint ; Hip ; Humans ; Immobilization ; Osteotomy

Three cases of congenital coxa vara were treated by subtroch-anterie abduction osteotomy with percutaneous pin fixation of both fragments. The indications of the corrective subtrochanteric osteotomy for coxa vara deformity were the neck-shaft angle of 100 degress or less, the presence of marked gluteus medius limp and the vertical neck defect with progression of the varus deformity. Through a lateral approach, the lateral aspect of the proximal end to the femoral shaft was exposed and 2 Steinmann pins were inserted through the upper and lower levels to the proposed osteotomy. The distal pin was inserted perpendicular to the long axis of the femur and the proximal pin at an algle of desired correction to the distal pin and a subtrochanteric transverse osteotomy was completed. Two Steinmann pins were paralell to each other by adducting the proximal fragment and abducting the distal fragment. and the lateral cortex of the proximal fragment was impacted into the marrow cavity of the distal fragment. The Steinmann pins were then incorporated in the hip spica cast. The object of the operation was to correct the coxa vara, to change the stress on the vertical fissure in the neck from shear to compression and to overcome shortening of leg. With this technically simple method, the authors achieved adequate correction of the deformity. The ostetomies healed rapidly and the medullary canal was re-established in all cases, The gait of each patient was markedly improved and the Trendelenburg test become negative in all of them. One of these patients showed a mild recurrence of varus deformity and limp 2 years following surgery.
Bone Marrow ; Congenital Abnormalities ; Coxa Vara ; Femur ; Gait ; Hip ; Humans ; Leg ; Methods ; Neck ; Osteotomy ; Recurrence

Congenital coxa vara is a rare congenital deformity, seen in infancy and childhood and the ratio of unilateral to bilateral is 3:1. The deformity does not become manifest until after birth and usually not until the age of walking. Pathologically, it consists of a progressively increasing acuteness of the neck-shaft angle;shortnees of the neck; a vertical direction of the epiphyseal plate; an oblique defect of the neck; a greater trochanter extending upward toward the ilium as a besk; a shortened femur; a secondary degenerative changese in the acetabulum due to malposition. We have experienced a case of bilateral congenital coxa vara treated with valgue osteotomy and the case review is presented.
Acetabulum ; Congenital Abnormalities ; Coxa Vara ; Femur ; Growth Plate ; Ilium ; Neck ; Osteotomy ; Parturition ; Walking

Subtrochanteric fracture of the femur is more difficult to treat than other bone fracture. Subtrochanteric fracture occurs in bone that is predominently cortical and biomechanical analyeis of stress in the femur ahowed that there is a high concentration of stress in the subtrochanteric region. These two factors, involvement of cortical bone tissue and concentration of stress, frequently have been mentioned as reasons for the high incidence of complications in the treatment of these fractures. The authors treated 23 cases of subtrochanteric fracture of the femur in 1974 through 1981, at the Department of Orthopaedic Surgery, School of Medicine, Soon Chun Hyang College. The results were as follows: 1. Of 23 cases of subtrochanteric fracture, 15 cases occurred in man, 8 cases in woman. 2. The most common cause of fracture was due to traffic accident. 3. Of 23 cases of subtrochanteric fracture, 9 cases were type lI, and 7 cases were type I & II by Fielding's classification. 4. 19 cases out of 23 were treated by means of the open reduction and internal fixation. As the internal fixation material, we used Kuntscher nail, Smith-Peterson and Thornton plate, Compression hip screw and plate until December 1978, and Zickel nail from January 1979. 5. The mean duration of bony union in subtrochanteric fracture treated by Zickel nail was shorter than the other implants. The incidence of complications such as coxa vara, delayed union, metal breakage occurred higher in the cases treated by Kuntscher nail, Smith-Peterson nail and Thornton plate, Campression hip screw and plate. 6. Zickel nail is one of the good implant for the treatment of subtrochanteric fracture of the femur.
Accidents, Traffic ; Bone and Bones ; Classification ; Coxa Vara ; Female ; Femur ; Fractures, Bone ; Hip ; Humans ; Incidence