Treatment of reduced femoral antetorsion by subtrochanteric rotational osteotomy.
The purpose of this study was to assess bone healing and complication rate following subtrochanteric rotational osteotomy fixed with a 4.5/5.0 Locking Compression Plate (LCP, Synthes) for reduced femoral antetorsion with early full weight bearing. The effects of the osteotomy on the range of internal rotation of the hip and complaints due to reduced antetorsion were also recorded. Between July 2004 and October 2007, 25 children (39 hips) with a mean age of 13 years (range, 9-18 years) were treated for reduced internal rotation of the hip by a subtrochanteric rotational osteotomy. Four patients (six hips) were excluded from this study due to concomitant surgeries prohibiting full weight bearing. Of the 21 patients who were allowed full weight bearing, nine had a unilateral and twelve a single-stage bilateral correction. We investigated time to union, implant failure, and complication rate as well as improvement in the range of internal rotation. All osteotomies healed without secondary displacement or angulation. Internal rotation improved from a mean of 8.6 degrees (-5 degrees to 20 degrees) preoperatively to 37.3 degrees (25 degrees to 60 degrees) postoperatively. We noted no complication related with the femoral osteotomy. Subtrochanteric rotational osteotomy appeared as a reliable procedure to improve internal rotation of the hip. Fixation with 4.5/5.0 LCP allows simultaneous bilateral correction and immediate full weightbearing with crutches, with a minimal risk of implant failure.
Department of Orthopaedic Surgery, University of Zurich, Balgrist Hospital, Zurich, Switzerland.
Hanspeter
H
Huber
Mathias
M
Haefeli
Stefan
S
Dierauer
Leonhard E
LE
Ramseier
D000293:Adolescent; D002648:Child; D005260:Female; D005269:Femur / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods*; D012399:Rotation; D016474:Weight-Bearing