coxa valga

Plain radiographs show only two dimensions of a three-dimensional object. On anteroposterior and lateral radiographs an implant may appear to be safely within the head of the femur although surface penetration has occurred. We have attempted to identify this complication in the treatment of fractures of the femoral neck and have analysed the position of a screw or pin in the femoral head and neck on the basis of orthogonal frontal and lateral radiographs. A retrospective analysis of 60 cases of osteosynthesis of fractures of the femoral neck confirmed the risk of non-recognition of articular penetration or breaking of the cortex of the neck during surgery...

We studied deformity of the proximal end of the femur following open reduction using the wide exposure method for developmental dislocation of the hip. We reviewed radiographs of 22 children with unilateral dislocation of the hip who had undergone open reduction between one and three years of age. Ages at final examination ranged from 14 to 21 years. None of the patients in this study had undergone any additional surgery. Avascular necrosis of the femoral head was not observed in any patients. Radiographic measurements were observed when the children were 3, 6, 9, and 12 years old, and at the final examination...

Twenty-two patients (33 hips) with congenital dislocation of the hip were examined at an average of 26 years after combined acetabuloplasty and intertrochanteric varus derotation osteotomy. Seventeen patients had no problems despite physically demanding jobs and sporting activities in some cases. The CE angle was improved to the lower end of the normal range. The shaft-neck angle was corrected by 31 degrees to 120 degrees. Restoration to the normal valgus subsequently occurred and we found no evidence of subcapital coxa valga...

We report on an Egyptian girl with phenotypic abnormalities of cerebro-oculofacio-skeletal syndrome. She had microcephaly, bilateral congenital cataract, nystagmus, long ear pinnae, camptodactyly, prominent heels, coxa valga, kyphosis and flexure contracture of the elbows and knees. CT scan showed bilateral symmetrical intracranial calcifications. In addition, she had an apparently balanced translocation: 46,XX,t(1;16)(q23;q13) in all cells transmitted from a phenotypically normal mother with a similar balanced translocation mosaicism...

Traumatic dislocations of the hip are much less frequent in children than in adults. If some complications are well known (avascular necrosis of the femoral head, recurrent dislocation), the lateralization of the head by x-ray transparency interposition is less appreciated. We report 4 cases of x-ray transparency interposition in 15 reductions of incomplete traumatic dislocation of the hip. These 4 dislocations were posterior in non-pathological hips, three on the left side and one on the right. Our reductions have been easy and the hips remained stable...

Pelizaeus-Merzbacher disease (PMD) is a degenerative leukodystrophy of the central nervous system resulting in progressive spasticity and neurologic deterioration. Seitelberger (13) divided this rare disease into six types. Five patients with the type 1 and two patients with the type II form of PMD have been treated at the Children's Hospital of Eastern Ontario. Our study sought to identify the orthopaedic manifestations of PMD and to develop a common orthopaedic profile for these patients. All children with types I and II PMD developed spastic quadriparesis, truncal hypotonia, thoracolumbar scoliosis, soft-tissue contractures of the adductors and hamstrings, osteopenia, bilateral coxa valga, and associated hip dislocation...

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Between 1973 and 1984, 70 modified Dega acetabuloplasties done simultaneously with intertrochanteric osteotomies in 51 patients with developmental dysplasia of the hip were reviewed for long-term results and analyzed for causes of failure. Mean patient age at operation was 2.9 years (range, 8 months-8 years), and mean followup time was 15.2 years (range, 10-19 years). Topical investigations were based on clinical criteria of the Severin classification and radiologic criteria of the Commission for the Study of Hip Dysplasia of the German Society of Orthopaedics and Traumatology...

The cases of 2 patients with valgus slipped capital femoral epiphysis are presented. Additional imaging studies provide support for true posterolateral epiphyseal displacement. Increased femoral anteversion and coxa valga contribute to the pathogenesis of valgus slipped capital femoral epiphysis. In situ pin fixation is recommended for stable valgus slipped capital femoral epiphysis. The importance of valgus slipped capital femoral epiphysis lies in its recognition and appropriate screw placement when internal fixation is used...

Excessive femoral and coxa valga have been reported to be major contributors leading to hip dislocation in patients with cerebral palsy (CP). Femoral torsion angle (FT) and neck-shaft angle (NSA) were measured by the radiographic technique described by Rippstein and Müller in 157 patients with CP (289 hips). Factors associated with the degree of FT and NSA were evaluated. The researchers explored the correlation between the two angles and hip pathology. A large database of measurements was constructed. Our findings suggest that age and ambulatory status are the main factors correlated with FT and NSA...

We report an 18-year-old boy with occipital horn syndrome and we review the 20 cases previously published with this syndrome. The distinctive features common to all patients were unusual facial appearance, skeletal abnormalities, chronic diarrhea and genitourinary abnormalities. The skeletal abnormalities included occipital horns, short, broad clavicles, deformed radii, ulnae, and humeri, narrowing of the rib cage, undercalcified long bones with thin cortical walls and coxa valga. Occipital horn syndrome is inherited in an X-linked recessive fashion...

A patient with unusual Hutchinson-Gilford syndrome (progeria) is reported. This 7-year-old boy had all the characteristics of progeria, except for coxa valga and the "horse-riding" stance. A previous cerebral infarction was detected in the right putamen on cranial magnetic resonance imaging. During treadmill exercise test electrocardiography, ST depression suggested the existence of arteriosclerotic lesions. Skin fibroblast culture exhibited 76% DNA-repair capacity compared to normal. He has not manifested endocrinologic abnormalities...

We report a patient with a sporadic case of oto-palato-digital (OPD) syndrome type II. Parents and five previous sibs are normal. At 26 years of age the patient had conductive hearing impairment, cleft palate, a prominent forehead, a flat facies, and a broad nasal base resulting in the characteristic "pugilistic" appearance. Extension and supination were limited at the elbows; thumbs and halluces were broad. Many radiological abnormalities were noted: malformations of the cervical spine, pelvic abnormalities, bilateral coxa valga, genu valgum, small fibulae, pes equino varus, and 15 carpal bones...

To our knowledge, progressive coxa valga, femoral anteversion, and hip subluxation after surgical resection of soft tissue tumors of the gluteal muscles have not been described. The importance of this paper is to document proximal femoral deformity and hip subluxation in children after tumor resection of the hip abductor muscles, to provide guidelines for diagnosis and management of this problem, and to avoid late complications of progressive joint incongruity. Late deformity was seen in two cases after limb salvage surgery for a soft tissue buttock tumor...

A consecutive sample of 411 hip roentgenograms in 215 patients with cerebral palsy was evaluated. Femoral anteversion and neck-shaft angles were measured and compared with hip stability indexes to determine which of the two angles is more important in hip instability. The correlation coefficients were higher and statistically significant for femoral anteversion and lower and statistically nonsignificant for neck-shaft angles. These findings suggest that increased femoral anteversion has greater correlation than increased coxa valga with hip instability in cerebral palsy patients and therefore should be addressed primarily when surgically treating these hips...

We describe a 22-month-old Japanese girl with severe microcephaly with a prominent nose and a receding chin, developmental delay, marked intrauterine and postnatal dwarfism with limb shortening and brachydactyly, and distinctive radiological changes of the skeleton. The radiological findings include hypoplasia of the short tubular bones, multiple pseudoepiphyses in the bases of the metacarpals, coxa valga, a wide pelvis with iliac flaring, thoracolumbar scoliosis, and disharmonious ossification delay. The clinical and radiological features are somewhat different from those of previously reported cases with osteodysplastic primordial dwarfism...

BACKGROUND: Hamartomatous dysplasias with hemihypertrophy are a part of several congenital diseases, sometimes difficult to classify when their symptomatology is relatively poor. CASE REPORTS: Case 1. A girl, 11 year-old, suffered from gigantism of the feet, left hemihypertrophy of the limbs, scoliosis and kyphosis. X-rays showed frontal hyperostose, bony and soft tissues overgrowth involving the left limbs and pelvis with hip dislocation and coxa valga. The vertebrae were hypertrophic and dysplastic...

We have studied the medium- and long-term effects of femoral intramedullary nailing in 34 children. There was a high incidence of abnormality at the proximal end of the femur, including coxa valga, arrest of growth of the greater trochanter and thinning of the neck of the femur, because of damage to the trochanterocervical growth plate. These disorders affected 30% of the patients, mostly under the age of 13 years (p < 0.05), and were seen more frequently when the nail had been introduced through the piriform fossa...

The association of Down's syndrome (trisomy 21) with clubfeet has not previously been elaborated. Eight patients with a total of 15 clubfeet were identified for review. Five of these had trisomy 21 noted by chromosomal analysis, and 1 had a mosaic pattern. Two patients did not have chromosomal documentation, but had characteristic features of Down's syndrome. Interestingly, 2 patients had evidence of arthrogryposis as well as Down's syndrome. Four of the 8 patients had other orthopedic anomalies, including scoliosis, atlantoaxial instability, brachydactyly, and coxa valga...

The development of the proximal femur was studied in a follow up of 64 patients--on average 24.4 years of age--with congenital hip dislocation and 101 subsequent aseptic necroses of the femoral head. For measurement of the angle of antetorsion and the femoral neck-shaft angle, biplanar radiographs were taken. A coxa valga with a true femoral neck-shaft of 137 to 164 degrees was present in one third of the cases with partial necrosis and in the group without necrosis. An increasing degree of necrosis led to coxa vara...