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LETTER TO EDITOR  
Year : 2012  |  Volume : 46  |  Issue : 2  |  Page : 254-255
Subtrochanteric valgus osteotomy in developmental coxa vara: A comment


Department of Orthopedic Surgery, Cheju Halla General Hospital, Jeju, Korea

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Date of Web Publication10-Mar-2012
 

How to cite this article:
Moon MS. Subtrochanteric valgus osteotomy in developmental coxa vara: A comment. Indian J Orthop 2012;46:254-5

How to cite this URL:
Moon MS. Subtrochanteric valgus osteotomy in developmental coxa vara: A comment. Indian J Orthop [serial online] 2012 [cited 2020 Jan 26];46:254-5. Available from: http://www.ijoonline.com/text.asp?2012/46/2/254/93697
Sir,

I read with great interest the article entitled "subtrochanteric valgus osteotomy in developmental coxa vara" by T El-Sobky published in the Indian Journal of Orthopedics. [1] We appreciate the authors for their good work but certain key points of their report are not clear. The authors stressed only the merits of Y-shaped osteotomy over the classic V-shaped osteotomy. However, they did not clearly provide it, based on several parameters such as [2] subtrochanteric fusion rates, [3] effect on leg length, [4] effect of one degree of deformity correction on leg length, and finally [5] the fate of the corrected femoral neck-shaft angle. The final shape of the neck at the time of growth maturity is a reliable indicator of successful management. [6],[7]

As far as the clinical experience of this reader on subtrochanteric closing and opening osteotomy 2 of the same disease is concerned issues were, frequently (a) delayed union, [3] (b) higher loss of correction at early post-operative stage, and [4] very little effect on leg length. Also it was already a known fact that the corrected deformity remodel to original shape at maturity. According to Shopner et al., in cases of intertrochanteric osteotomy, the corrected neck-shaft angle remodel to the original shape within three years; which in cases of the subtrochanteric osteotomy takes six to eight years. The early loss of correction is due to union failure at osteotomy site or fixation failure, while the gradual loss of correction is due to natural remodeling. The average followup is also not clear. The final success should be made by the final neck-shaft angle and leg length at the time of growth maturity.

 
   References Top

1.El-Sobky T. Subtrochanteric valgus osteotomy in developmental coxa vara. Indian J Orthop 2011;45:320-3.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Shopner CE, Cramer R, Cramer R. Growth remodeling of ling bone osteotomies. Br J Radiol 1973;46:512-9.  Back to cited text no. 2
    
3.Ryöppy S, Karahaju EO. Alteration of epiphyseal growth by an experimentally produced angular deformity. Acta Orthop Scand 1974;45:490-8.  Back to cited text no. 3
    
4.Hall-Craggs DC. Influence of epiphyses on the regulation of bone growth. Nature 1969;221:1245.  Back to cited text no. 4
    
5.Karaharju EO, Ryöppy SA, Mankinen RJ. Remodeling by symmetrical epiphyseal growth. J Bone Joint Surg 1976;58B:122-6.  Back to cited text no. 5
    
6.Kwon DJ, Moon MS. The influence of physeal injury upon growth correction of deformed rat tibia. Int Surg 1980;65:341-5.  Back to cited text no. 6
    
7.Moon MS, Kim BK. The influence of severity of angulatory deformity of rat's tibia on spontaneous correction. Int Surg 1982;67:537-9.  Back to cited text no. 7
    

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Correspondence Address:
Myung-Sang Moon
Department of Orthopedic Surgery, Cheju Halla General Hospital, Jeju
Korea
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5413.93697

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This article has been cited by
1 TUBERCULOUS KYPHOSIS — EVOLVING CONCEPTS IN PREVENTION AND TREATMENT
Myung-Sang Moon,Sung-Soo Kim,Jang-Cheol Sihn
Journal of Musculoskeletal Research. 2015; 18(03): 1530002
[Pubmed] | [DOI]
2 Authoræs reply
El-Sobky, T.
Indian Journal of Orthopaedics. 2012; 46(2): 255
[Pubmed]



 

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