Literature DB >> 22448073

Subtrochanteric valgus osteotomy in developmental coxa vara: A comment.

Myung-Sang Moon1.   

Abstract

Entities:  

Year:  2012        PMID: 22448073      PMCID: PMC3308676          DOI: 10.4103/0019-5413.93697

Source DB:  PubMed          Journal:  Indian J Orthop        ISSN: 0019-5413            Impact factor:   1.251


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Sir, I read with great interest the article entitled “subtrochanteric valgus osteotomy in developmental coxa vara” by T El-Sobky published in the Indian Journal of Orthopedics.1 We appreciate the authors for their good work but certain key points of their report are not clear. The authors stressed only the merits of Y-shaped osteotomy over the classic V-shaped osteotomy. However, they did not clearly provide it, based on several parameters such as2 subtrochanteric fusion rates,3 effect on leg length,4 effect of one degree of deformity correction on leg length, and finally5 the fate of the corrected femoral neck-shaft angle. The final shape of the neck at the time of growth maturity is a reliable indicator of successful management.67 As far as the clinical experience of this reader on subtrochanteric closing and opening osteotomy 2 of the same disease is concerned issues were, frequently (a) delayed union,3 (b) higher loss of correction at early post-operative stage, and4 very little effect on leg length. Also it was already a known fact that the corrected deformity remodel to original shape at maturity. According to Shopner et al., in cases of intertrochanteric osteotomy, the corrected neck-shaft angle remodel to the original shape within three years; which in cases of the subtrochanteric osteotomy takes six to eight years. The early loss of correction is due to union failure at osteotomy site or fixation failure, while the gradual loss of correction is due to natural remodeling. The average followup is also not clear. The final success should be made by the final neck-shaft angle and leg length at the time of growth maturity.
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1.  Remodelling by asymmetrical epiphysial growth. An experimental study in dogs.

Authors:  E O Karaharju; S A Ryöppy; R J Mäkinen
Journal:  J Bone Joint Surg Br       Date:  1976-02

2.  Alteration of epiphyseal growth by an experimentally produced angular deformity.

Authors:  S Ryöppy; E O Karaharju
Journal:  Acta Orthop Scand       Date:  1974

3.  Growth remodelling of long bone osteotomies.

Authors:  C E Shopfner; R Cramer; R Cramer
Journal:  Br J Radiol       Date:  1973-07       Impact factor: 3.039

4.  Influence of epiphyses on the regulation of bone growth.

Authors:  E C Hall-Craggs
Journal:  Nature       Date:  1969-03-29       Impact factor: 49.962

5.  The influence of severity of angulatory deformity of rat's tibia on spontaneous correction.

Authors:  M S Moon; B K Kim
Journal:  Int Surg       Date:  1982 Oct-Dec

6.  The influence of physeal injury upon growth correction of deformed rat tibia.

Authors:  D J Kwon; M S Moon
Journal:  Int Surg       Date:  1980 Jul-Aug

7.  Subtrochanteric valgus osteotomy in developmental coxa vara.

Authors:  Tamer El-Sobky
Journal:  Indian J Orthop       Date:  2011-07       Impact factor: 1.251

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1.  Author's reply.

Authors:  Tamer El-Sobky
Journal:  Indian J Orthop       Date:  2012-03       Impact factor: 1.251

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