R Placzek1, M Gathen2, S Koob2, C Jacobs2, M M Ploeger2. 1. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland. richard.placzek@ukbonn.de. 2. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
Abstract
OBJECTIVE: Growth disorders (e. g. caused by congenital hip dislocation, Perthes disease or bacterial coxitis) often lead to an infantile deformity of the proximal femur with a shortened femoral neck and displaced grater trochanter. In 1988, Morscher and Buess described a femoral neck lenghtening osteotomy for treatment of adults. For the first time, we show a modification of this osteotomy for children and adolescents with a locking plate system. The aim is to restore the normal anatomy of the femoral neck and biomechanics of the proximal femur. INDICATIONS: All symptomatic deformities of the proximal femur with a shortened femoral neck and a proximal displacement of the greater trochanter. CONTRAINDICATIONS: Bacterial coxitis within the last two years; elevated infections parameters. Acetabular dysplasia with a lack of femoral head containment. SURGICAL TECHNIQUE: Two osteotomies: one at the level of the greater trochanter to transfer it. The second osteotomy at the level of the distal femoral neck. Stabilization with a locking plate system (LCP Pediatric Hip Plate 130°, Synthes, Oberdorf, Switzerland). POSTOPERATIVE MANAGEMENT: Full weight bearing to a body weight of 55 kg; partial weight bearing with a body weight >55 kg for 6 weeks. RESULTS: No intraoperative or postoperative complications were observed in 5 female patients (mean age 11.67 years). After a follow-up of 6-12 weeks, none of the patients presented a Trendelenburg's sign. After 3-6 months, full range of motion was possible.
OBJECTIVE:Growth disorders (e. g. caused by congenital hip dislocation, Perthes disease or bacterial coxitis) often lead to an infantile deformity of the proximal femur with a shortened femoral neck and displaced grater trochanter. In 1988, Morscher and Buess described a femoral neck lenghtening osteotomy for treatment of adults. For the first time, we show a modification of this osteotomy for children and adolescents with a locking plate system. The aim is to restore the normal anatomy of the femoral neck and biomechanics of the proximal femur. INDICATIONS: All symptomatic deformities of the proximal femur with a shortened femoral neck and a proximal displacement of the greater trochanter. CONTRAINDICATIONS: Bacterial coxitis within the last two years; elevated infections parameters. Acetabular dysplasia with a lack of femoral head containment. SURGICAL TECHNIQUE: Two osteotomies: one at the level of the greater trochanter to transfer it. The second osteotomy at the level of the distal femoral neck. Stabilization with a locking plate system (LCP Pediatric Hip Plate 130°, Synthes, Oberdorf, Switzerland). POSTOPERATIVE MANAGEMENT: Full weight bearing to a body weight of 55 kg; partial weight bearing with a body weight >55 kg for 6 weeks. RESULTS: No intraoperative or postoperative complications were observed in 5 female patients (mean age 11.67 years). After a follow-up of 6-12 weeks, none of the patients presented a Trendelenburg's sign. After 3-6 months, full range of motion was possible.
Entities:
Keywords:
Coxa vara; Hip dislocation; Leg length inequality; Perthes disease; Surgical procedures
Authors: Claudia Druschel; Katherina Heck; Peter Heinrich Pennekamp; Matthias Wimmer; Julia Franziska Funk; Richard Placzek Journal: Int Orthop Date: 2015-07-31 Impact factor: 3.075
Authors: Milena M Ploeger; Martin Gathen; Sebastian Koob; Matthias D Wimmer; Richard Placzek Journal: Oper Orthop Traumatol Date: 2021-12-06 Impact factor: 1.154