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 Table of Contents    
LETTER TO EDITOR  
Year : 2012  |  Volume : 46  |  Issue : 2  |  Page : 255
Author's reply


Department of Orthopaedic Surgery, Faculty of Medicine, Ain Shams University, Abbassia 11566 Cairo, Egypt

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Date of Web Publication10-Mar-2012
 

How to cite this article:
EL-Sobky T. Author's reply. Indian J Orthop 2012;46:255

How to cite this URL:
EL-Sobky T. Author's reply. Indian J Orthop [serial online] 2012 [cited 2020 Jan 26];46:255. Available from: http://www.ijoonline.com/text.asp?2012/46/2/255/93698
Sir,

Thanks for expressing interest [1] in the article titled, "Subtrochanteric valgus osteotomy in developmental coxa vara," published in Indian Journal of Orthopaedics, [2] and for delivering valuable comments. The purpose of the study was two fold. The first was offering an alternative method of rigid and stable fixation that alleviates the need of postoperative spica application to provide immobilization. The second purpose of the study was related to modification of the Pauwel's Y-shaped intertrochanteric osteotomy.

In this study, no direct correlation was drawn between the deformity correction in degrees and leg length in millimeters. Nevertheless, it has been theoretically and clinically verified that the same amount of deformity correction can be achieved with less amount of shortening in Y-shaped osteotomy than the classic V osteotomy. [3] Besides, a direct correlation needs the osteotomy site to be fixed in relation to an anatomical landmark. Otherwise, measurement errors related to different osteotomy sites may undermine the validity of the correlation. In the current study, the site of the subtrochanteric osteotomy was not fixed.

The subtrochanteric osteotomy did delay the union radiologically, but this did not have any clinical influence because all children were allowed to start weight bearing after 8 weeks based on progress of union and rigidity of fixation without waiting for full radiographic union.

The relatively short followup was the limitation to the study. The true incidence of recurrence may be missed in such studies. [4],[5],[6] In the current study, it was stated that secondary subtrochanteric deformity remodels considerably though not fully. Longer followup periods are warranted.

 
   References Top

1.Moon MS. Subtrochanteric valgus osteotomy in developmental coxa vara: A comment. Indian J Orthop 2012;46:254-5.  Back to cited text no. 1
  Medknow Journal  
2.EL-Sobky T. Subtrochanteric valgus osteotomy in developmental coxa vara. Indian J Orthop 2011;45:320-3.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.Pauwels F. Biomechanics of the normal and diseased hip. New York: Springer-Verlag; 1976.  Back to cited text no. 3
    
4.Herring JA. Tacchdijian's paediatric orthopedics. 3 rd ed. USA: W.B. Saunders Company; 2002.  Back to cited text no. 4
    
5.Dobbs MB, Morcuende JA. Other condition of the hip: Coxa vara. In: Morrissy RT, Weinstein SL, Editors. Lovell and Winter's Pediatric Orthopedics, 6 th ed. New York: Lippincott Williams and Wilkins; 2005. p. 1126-34.  Back to cited text no. 5
    
6.Hassan T. Surgical correction of infantile coxa vara. Egyp Orthop J 2007;1:40-6.  Back to cited text no. 6
    

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Correspondence Address:
Tamer EL-Sobky
Department of Orthopaedic Surgery, Faculty of Medicine, Ain Shams University, Abbassia 11566 Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


PMID: 22448074

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