Exactness of Correction of Proximal Femoral Deformities Using Conventional Angled Blade Plates and the Cannulated Paediatric Osteotomy System. Comparison of Two Methods

BackgroundProximal femoral osteotomy is the most common major reconstructive surgery in the region of the hip joint in children and adolescents. Given that it may be required across a wide range of ages and indications, appropriate instrumentation is necessary to ensure a technically satisfactory result. Recent developments in fixation include cannulation of the blade plate and locking screw technology.MethodsWe conducted a prospective audit of our first 25 patients who had a unilateral or bilateral proximal femoral osteotomy using a recently available system which combines cannulation and locking plate technology. The principal outcome measures were the radiographic position of the osteotomy at the time of union and surgical adverse events.ResultsForty-five proximal femoral osteotomies were performed in 25 patients, mean age 8 years (range 3–17 years), for a variety of indications, the most common of which was hip subluxation in children with cerebral palsy. All osteotomies were soundly united by 6 weeks in children and by 3 months in adolescents, in the position achieved intra-operatively. There were no revision procedures and the technical goals of surgery were achieved in all patients. There was one adverse event, a low-grade peri-prosthetic infection, diagnosed at the time of implant removal.ConclusionsIn this prospective audit of our first 25 patients, the new system performed well across a wide range of ages, body weights and surgical indications. Further comparative studies will be required to determine whether it offers additional advantages over more traditional systems.

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Cannulated, locking blade plates for proximal femoral osteotomy in children and adolescents

Zhou

Camp

Gahukamble

et al. 2015

Journal of Children's Orthopaedics

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A modified angled plate for fixation of proximal femoral varus osteotomy in neuromuscular hip dislocation: Mechanical and clinical study

Abuomira,

El-Alfy,

Seddik

et al. 2024

Orthopaedics & Traumatology: Surgery & Research

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Proximal femoral osteotomy in children with cerebral palsy: The perspective of the trainee

Zhou

Camp

Gahukamble

et al. 2017

Journal of Children's Orthopaedics

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BackgroundThere are a range of implants for fixation of proximal femoral osteotomies (PFOs) in children. We investigated the training experiences and preferences of orthopaedic residents and fellows who were learning PFO, using a fixed angled blade plate (ABP) or a locking, cannulated blade plate (LCBP). We also studied short-term technical and radiographic outcomes.MethodsThis was a prospective, parallel-group, cohort study of 90 consecutive children and adolescents with cerebral palsy who underwent bilateral PFOs with ABP or LCBP. Surgical trainees completed a questionnaire to document the ease or difficulty of each operative step.ResultsThere were 48 boys and 42 girls, with a mean age of eight years and a mean follow-up of 25 months. Trainees preferred the LCBP system for: insertion of the guidewire, the seating chisel and the blade plate, as well as overall technical ease of use (p < 0.001). Radiographic outcomes were similar with no between-group differences for migration percentage (p = 0.996) or neck shaft angle (p = 0.849), but there was a higher prevalence of technical errors in the ABP group.ConclusionsTrainee surgeons expressed a preference for LCBPs when learning PFO in children with cerebral palsy. Radiographic outcomes were similar in both groups, with close attending surgeon supervision.

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Exactness of Correction of Proximal Femoral Deformities Using Conventional Angled Blade Plates and the Cannulated Paediatric Osteotomy System. Comparison of Two Methods

Cited by 5 publications

References 9 publications

Cannulated, locking blade plates for proximal femoral osteotomy in children and adolescents

Cannulated, locking blade plates for proximal femoral osteotomy in children and adolescents

A modified angled plate for fixation of proximal femoral varus osteotomy in neuromuscular hip dislocation: Mechanical and clinical study

Proximal femoral osteotomy in children with cerebral palsy: The perspective of the trainee

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