Coxa vara is an uncommon orthopaedic condition. Problems associated with the definition, radiological appearance, classification and surgical treatment are discussed. A clinical and radiological review of 11 patients (14 hips) treated with a LCP plate (Synthes) in our paediatric orthopaedic unit from 2010 to 2013 was performed. These hips were classified as congenital (6), developmental (3) and acquired (5). The Hilgenreiner Epiphyseal (HE) angle, the head/shaft angle and the neck/shaft angle were all assessed and examples shown why one measurement does not address every case.Introduction
Methods
Management of the sequelae of arthritis of the hip joint has changed over time. Total joint replacement has gained popularity due to retained mobility and stability. In the high demand paediatric and adolescent population problems are encountered with longevity of the procedure. Hip arthrodesis is a useful alternative procedure that sacrifices mobility of the joint to achieve pain relief and restores function. Several surgical techniques have been described to achieve hip fusion. We describe a technique that achieves concentric bone surfaces with hip resurfacing reamers. Maximum bone is preserved to maintain leg length. Trans-articular compression is achieved with cannulated screw fixation. Subtrochanteric de-functioning osteotomy completes the procedure to protect the fusion site and control the position of the limb. Our optimal position of fusion was 30 degrees of flexion, neutral to 5 degrees of abduction and neutral to 10 degrees of external rotation. Fourteen patients (8 female) treated by hip arthrodesis over a two-year period are reviewed in terms of clinical and radiological outcome in the short term. Their mean age at hip fusion was 11 years (6–18). The etiology included TB (6 cases), staphylococcal infection (2), non-specific arthritis (3), Perthe's (1), chondrolysis (1) and avascular necrosis following trauma (1).Introduction
Methods
