Midterm Results After Subtrochanteric End-to-Side Valgization Osteotomy in Severe Infantile Coxa Vara

Günther, Christian; Komm, Moritz; Jansson, Volkmar; Heimkes, Bernhard

doi:10.1097/bpo.0b013e3182812194

Cited by 19 publications

(23 citation statements)

References 20 publications

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“…Joeris et al [4], who used Pediatric Hip Plates of 150°, had more girls and heavier children in their study than we did and presented a population that was even more heterogeneous than ours. Similarly, a comparable heterogeneity was found in studies by Skaggs et al [22], Burns et al [15], Günther’s [12], Widman’s [18], and Cordes et al [24]. …”

Section: Discussionsupporting

confidence: 71%

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LCP 140° Pediatric Hip Plate for fixation of proximal femoral valgisation osteotomy

Sidler-Maier

Reidy

Huber

et al. 2014

Journal of Children's Orthopaedics

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PurposeFemoral osteotomy is one of the most widely performed reconstructive operations in pediatric orthopedic surgery. Many implants for fixation have been used, but so far there is no literature about the application and outcome of the LCP 140° Pediatric Hip Plate for proximal femoral valgisation in children.MethodsData of patients with a valgisation of the proximal femur using the LCP 140° Pediatric Hip Plate between February 2011 and July 2012 were retrospectively collected and analyzed.ResultsWe included 10 patients (11 hips) with a mean follow-up of 15.3 ± 6.3 months (range 5.6–23 months). The mean age was 9.6 ± 1.2 years (range 7.3–11.8 years) with a mean hospital stay of 5.2 ± 1.7 days (range 3–9 days). Callus formation was observed in all cases at 6 weeks postoperative control and consolidation was shown after a mean time of 14.1 ± 2.3 weeks (range 12.1–19.1 weeks). There was no delayed union or any case of non-union in our series. The stability of the operative reduction including the corrected neck-shaft angle (mean 19° ± 7.9°; range 10.5°–38.5°) was maintained during the follow-up period. No cases of recurrence (varisation) or complications requiring further treatment or revision were observed.ConclusionsIn our series, the 140° LCP Pediatric Hip Plate was shown to be safe and applicable in the clinical setting with good results. We therefore consider this device to be valuable for the correction of pathologic varus conditions of the proximal femur in children.

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Section: Discussionsupporting

confidence: 71%

“…According to Günther et al [12], deformities of the infantile hip requiring valgisation are encountered very infrequently. Likewise, the number of patients in our study being treated with a valgisation osteotomy is rather little, but larger or at least as big as in others studies [2–4, 15, 19, 22, 24].…”

Section: Discussionmentioning

confidence: 99%

LCP 140° Pediatric Hip Plate for fixation of proximal femoral valgisation osteotomy

Sidler-Maier

Reidy

Huber

et al. 2014

Journal of Children's Orthopaedics

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“…5a, b). Dann sind die Hüftabduktoren mehr in die Waagerechte verkippt und geschwächt, die Trochanterresultierende neigt sich zur Senkrech-ten und verursacht ein vertikales Über-wachstum des Trochanter major [8].…”

Section: Die Apophyse Des Trochanter Majorunclassified

“…5a, b 9 Bei geschä-digter Epiphysenfuge verkürzt sich der Schenkelhals, die konsekutiv flacher eingestellten und geschwäch-ten Abduktoren verkippen den Trochanter major in eine vertikale Wachstumsrichtung ("Trochanterrakete", aus [8] …”

Section: Der Orthopäde 3 · 2016 209unclassified

Die großen Apophysen

Heimkes

2016

Orthopäde

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Zusammenfassung Hintergrund Apophysen und Apophysenfugen unterscheiden sich in ihrem Aufbau nicht wesentlich von Epiphysen und Epiphysenfugen, im Gegensatz zu diesen tragen sie jedoch nicht zum Längenwachstum der Extremitäten bei. Sie sind den jeweilig benachbarten Gelenken zugeordnet. Das apophysäre Wachstum bestimmt hierbei Hebellängen und beeinflusst die Gelenkform und -struktur. Der formative Reiz hierzu geht von Muskeln aus, die sehnig an den Apophysen inserieren oder diese überwölben. Apophyse des Trochanter major Die Apophyse des Trochanter major trägt wesentlich zur Kraftarmlänge des Hüftgelenkes bei. Ihre Wachstumsleistung bestimmt, ob sich der Schenkelhals valgisch oder varisch entwickelt, letztendlich hängt davon auch ab, ob eine Hüfte dezentriert oder nicht. Tibiaapophyse Die Tibiaapophyse gibt vor, wie stark das Tibiaplateau nach ventral oder dorsal geneigt ist (tibialer Slope) und beeinflusst somit die sagittale Stabilität des Kniegelenkes. Ist sie verletzt, dann entwickelt sich ein schwierig zu behandelndes Genu recurvatum. Calcaneusapophyse Die Calcaneusapophyse gibt die Länge und Stellung des Fersenbeines vor und trägt hiermit entscheidend zum Drehmoment des oberen Sprunggelenkes bei. Zusammenfassung Zusammenfassend lässt sich sagen, dass Apophysen als Stellschrauben angesehen werden können, welche das Wachstum, die Form und Struktur ihrer benachbarten Gelenke lenken.

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“…Çok küçük çocuklarda tespit zorlukları yaşanır-ken; çocuğun büyümesini beklemek, koksa vara deformitesinin ve ikincil gelişen asetabular displazinin artmasına ve düzeltme sonrası asetabulumun remodelizasyon potansiyelinin yaş nedeniyle az olmasına bildirmişlerdir. [16] Yine aynı yıl Hefny ve arkadaşları, eksternal fiksatör ile tespit edilen dokuz subtrokanterik valgus osteotomisi yapılmış hastanın en az iki yıllık takip sonuçlarının iyi olduğunu bildirmişlerdir. Yazarlar eksternal fiksatör kullanılarak daha iyi ve kontrollü bir düzelme sağlandığını, klasik kamalı plakla yapılan cerrahiye göre daha az kanama olduğunu, insizyonun daha az olduğunu ve plağı çıkarmak için gereken ikinci cerrahiye gerek duyulmadığını belirtmişlerdir.…”

Section: Radyoloji̇k Bulgularunclassified