2000, Number 5
Acta Ortop Mex 2000; 14 (5)
Lengthening osteotomy of the femoral neck in children
Redon TA, García PG, Blancas VME, García UJA
Full text
Language: Spanish
References: 6
Page: 373-380
PDF size: 98.05 Kb.
ABSTRACT
Femoral neck shortening appears as a result of necrosis of the femoral head and damage to its growing plate, which can be produced by several lesions in the growing hip such as septic arthritis, developmental dysplasia of the hip and trauma, as well as in coxa brevis. The pathomechanics of such a hip involves an impairment on the lateral lever arm of the Pauwel’s balance and an increase of the medial moment which results in a dislocating force when the acetabulum is dysplastic. Otherwise it produces overloading on the supero-lateral articular surface of the head when the roof is normal. The proposed lengthening technique consists on an oblique subtrochanteric osteotomy which is directed lateral and downwards through a posterior approach. Femoral shaft is then fixed on to the lateral aspect of the trochanteric region and a second upper and parallel osteotomy is made on the base of the greater trochanter for advancing it lateral and downwards as well. Once performed the osteotomy, the increased length of the femoral neck is as long as the transverse diameter of the femoral shaft. Since 1995, 6 pediatric patients have been operated on because of shortening of the femoral neck, as a result of diverse pathology. Once healed the osteotomy, the neck length increased in all cases as it was expected. When there was shortening of the femoral shaft it remained unchanged. In all cases improvement of the lateral moment of the Pauwel’s balance was obtained since no patient had postoperative limping.REFERENCES