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Title: Surgical correction of coxa vara: Evaluation of neck shaft angle, Hilgenreiner-epiphyseal angle for indication of recurrence
Authors: Thammanoon Srisaarn
Krits Salang
Benjamin Klawson
Kitiwan Vipulakorn
Ornusa Chalayon
Perajit Eamsobhana
Washington University School of Medicine in St. Louis
Faculty of Medicine, Thammasat University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Phramongkutklao College of Medicine
Keywords: Medicine
Issue Date: 1-May-2019
Citation: Journal of Clinical Orthopaedics and Trauma. Vol.10, No.3 (2019), 593-598
Abstract: © 2018 Background: Coxa vara is a hip deformity in which the femoral neck-shaft angle decreases below its normal value. Standard surgical treatment for this condition is corrective valgus osteotomy. Appropriate correction of the Hilgenreiner-epiphyseal angle is important to prevent recurrence. The purpose of this study is to: 1) evaluate the recurrence of the deformity at the latest follow up; and 2) find the appropriate angle of correction associated with the lowest recurrence. Methods: 34 hips in 31 patients who underwent surgery for treatment of coxa vara from 2005 to 2014 were included. Patient-reported outcomes, Hilgenreiner-epiphyseal angle, and neck-shaft angle were assessed preoperatively, postoperatively, and at latest follow-up. Results: The mean age at surgery was 10.99, with a range of 5–30, years. Preoperative neck-shaft angle ranged from 60 to 100 degrees, and Hilgenreiner-epiphyseal angle ranged from 60 to 90 degrees. At the latest follow up, the neck-shaft angle ranged from 120 to 135 degrees and the Hilgenreiner-epiphyseal angle ranged from 22 to 35 degrees (p < 0.001). The Harris hip score improved from 47.20 (34–66) to 79.68 (60–100) (p < 0.001). There was no recurrence of deformities at the mean follow up of 37.87 months. Conclusion: Surgical correction of coxa vara in various pathologies can be done successfully with the Hilgenreiner-epiphyseal angle corrected to ≤ 35 degrees or the neck shaft angle corrected to > 120 degrees in order to prevent recurrence of the deformity. Majority of the patients were reported improvement of hip function. However, a longer-term follow up is required to determine further outcomes regarding to recurrence of the deformity.
ISSN: 22133445
Appears in Collections:Scopus 2019

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