Intertrochanteric versus supracondylar osteotomy for severe femoral anteversion.
Severe femoral anteversion may require operative correction if it results in cosmetic or functional disability. Complication rates < or = 15% have been reported after derotational osteotomy. We report the results of 51 osteotomies in 27 patients with idiopathic femoral anteversion over a 15-year period at a major pediatric orthopaedic referral center. Thirty-four derotational osteotomies in 17 patients were performed using a supracondylar technique with crossed-pin fixation. There was a 14.7% complication rate. Sixteen osteotomies in 10 patients were performed using an intertrochanteric osteotomy and blade-plate fixation with the patient in the prone position; there were no reported complications. The intertrochanteric osteotomy allowed more accurate correction of the intoeing deformity and decreased the need for postoperative immobilization. In addition, the more secure blade-plate fixation benefits the active child > 8 years of age who requires operative correction of severe femoral anteversion.
Payne
L Z
LZ
Department of Orthopaedic Surgery and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut.
DeLuca
P A
PA
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies