title: Valgus intertrochanteric osteotomy for coxa vara of Bucholz-Ogden Types II and III in patients older than 30 years.
abstract: BACKGROUND
  Ischemic necrosis of the proximal femur resulting in coxa vara is a severe iatrogenous complication of the treatment of developmental dysplasia of the hip (DDH). Severe relative overgrowth of the greater trochanter and reduction of the neck result in insufficiency of hip abductors. Unequal limb length causes obliquity of the pelvis, compensatory scoliosis of the lumbar spine and valgus deformity of the ipsilateral knee. The purpose of this study was to investigate the effect of valgus intertrochanteric osteotomy in patients with coxa vara older than 30 years.
  
  
  METHODS
  Fifteen female patients of the average age 43 years (range 31-60) with postdysplastic varus deformity of the proximal femur and shortening of affected limb of 2-4 cm were treated with valgus intertrochanteric osteotomy. None of them was operated on before. In eight cases, the varus deformity of the proximal femur was evaluated as Bucholz-Ogden Type II, in seven cases as Bucholz-Ogden Type III. The average follow-up was 10 years (range 5-20).
  
  
  RESULTS
  By the time of the last functional follow-up, three patients had already underwent conversion of osteotomy to total hip arthroplasty (THA), namely, 7.5, 11, and 12 years after osteotomy. All the patients evaluated the effect of osteotomy positively, including those treated later with THA. The average preoperative Harris Hip Score was 83, the postoperative one was 93.
  
  
  CONCLUSIONS
  Based on results, the valgus intertrochanteric osteotomy appears to be a reliable treatment for postdysplastic coxa vara in patients older than 30 years.
authors.affiliation: Department of Surgery of the 1st Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic. bartonicek.jan@seznam.cz
authors.forename: Jan
authors.initials: J
authors.lastname: Bartoníček
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Vávra
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D060905:Coxa Vara / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D010020:Osteonecrosis / Q000150:complications; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome